The vote tally for the Senate health care bill Photo: AP

Wow. Talk about close. 219-212. No wonder the anti-abortion Democrats were able to secure some last-minute concessions. If four representatives had switched sides, Obama would have lost the vote.

Has America been more politically divided over an issue since the Civil War? Civil Rights? At least that issue cut across party lines, whereas health care reform — or “socialised medicine”, as its opponents call it — has divided the parties right down the middle. Not a single Republican voted for the bill. (Admittedly, 34 Democrats voted against it.) This was a bitterly fought legislative campaign that gave the lie to Obama’s claim that his Presidency would be “postpartisan”. He is the most partisan President in living memory.

In this respect, Obama has had to conduct himself more like a British Prime Minister than an American Head of State. When I studied A-level politics back in the Reagan era, I remember being taught that the two great American political parties, unlike ours, only existed as electoral machines. They coalesced around one candidate every four years, then fractured again, with Presidents bolting together bi-partisan coalitions to push through legislation. The President didn’t depend for his survival on retaining the support of his party in the same way that our Prime Minister does and, hence, his party didn’t have to stay together after he’d been elected, at least not to the same extent. This, I was taught, was one of the advantages of America’s separation of powers. Because the executive branch of the government didn’t need to control the legislative branch in order to remain in office, it hadn’t developed anything like the same control mechanisms as the British Prime Minister. This meant the British people had more to fear from the centralisation of power than Americans. Elective dictatorship — the phrase Lord Hailsham coined to describe the dominance of Parliament by the government of the day — was a greater threat to Britain than it was to America.

The emergence of elective dictatorship in America — with the President having to use every stick at his disposal to beat his parliamentary party into submission — is surely one of the least attractive aspects of Obama’s Presidency. According to today’s New York Times:

Never in modern memory has a major piece of legislation passed without a single Republican vote. Even President Lyndon B. Johnson got just shy of half of Republicans in the House to vote for Medicare in 1965, a piece of legislation that was denounced with many of the same words used to oppose this one. That may be the true measure of how much has changed in Washington in the ensuing 45 years, and how Mr. Obama’s own strategy is changing with the discovery that the approach to governing he had in mind simply will not work.

“Let’s face it, he’s failed in the effort to be the nonpolarizing president, the one who can use rationality and calm debate to bridge our traditional divides,” said Peter Beinart, a liberal essayist who is publishing a history of hubris in politics.

It seems unlikely, to put it mildly, that this is the end of the affair. No doubt the Republicans in the Senate have a few delaying tricks up their sleeves and opponents of the bill, having failed to stop its passage in the legislative branch of the government, will switch their attention to the judicial branch. It will be interesting to see how far Obama can use the powers vested in him as President to railroad through these reforms. An elected dictator? I cannot see a freedom-loving people putting up with such a figure for long.