Some myths got slain last night in Washington DC. For one thing, the Democratic party rediscovered its vertebrae and used it, for a change, to pass healthcare reform. For another, the myth that the US political structure is broken and cannot digest fundamental issues … well, it took a dent.

Minutes after the final passage of the bills through the House of Representatives, President Obama got on with selling the reforms to the American public, going live on television despite the late hour. "This is what change looks like," Obama said, minutes before midnight, tying together his election promises of change with his commitments to reforming healthcare. "We proved that this government of the people and by the people still works for the people."

Obama looked exhausted, having spent the weekend winning over House Democrats. Bismark's epigram equating the messy business of passing legislation and making sausages has been repeated so often during Congress's healthcare debate that US cable news viewers on Sunday night might have expected to see meat-grinders operating in Congress.

But if there was any blood on the floor during the closing moments of the vote on healthcare reform, it came from the Republican party, whose members looked dangerously close to opening their own veins.



There was John Boehner, the most senior House Republican, giving a splenetic harangue punctuated with "Hell no!", in place of summing up his party's case. Then there was the mystery Republican congressman who shouted "baby killer" at Democrat Bart Stupak when Stupak swatted away a Republican procedural amendment aimed at killing the bill.

Stupak was a vital figure yesterday. It was his last-minute deal with Obama that led his bloc of conservative, anti-abortion Democrats to vote for the bill. That was why the Democratic leadership looked relaxed as the final vote approached. Shortly after 10.45pm, the floor of the House erupted into cheers as the 216th "yea" vote, the crucial casting one, sent healthcare reform onto the statute books and into the history books.

Nancy Pelosi, the speaker, had consistently predicted that she would have the votes when it came down to it. Once again, Pelosi delivered, proving herself to be the best Democratic parliamentary manager since Sam Rayburn. At this rate they'll have to name a building after her.

But since nothing is ever perfect in Washington, there's always room for criticism. They call it "Monday morning quarterbacking" in America – using the benefit of hindsight to sound insightful about the tactics that a team should have used. It's Monday morning and there will be plenty of quarterbacking going on over the healthcare reform vote last night, most of it fruitless.

The key fact from last night's vote is not what the margin was or the procedure used. The fact that it happened at all that was the real miracle. "Tonight at a time when the pundits said it was no longer possible, we rose above the weight of politics," Obama said in his late-night post-vote address.

A few weeks ago, the prospects for healthcare reform looked dead, after the Republicans appeared to be riding a backlash that won it the jewel of Ted Kennedy's old Senate seat. But two and a half months later and here we are: picking over a Democratic victory that remakes the US healthcare system.

Let's not forget that this process formally began a year ago. In that time Barack Obama expended an unusually high amount of political capital in backing the legislation – more than Bill Clinton expended in his hand-wringing attempt to overhaul healthcare, and far more than George Bush in his ham-fisted attempt to remake social security. Obama has now surpassed them both in constructing domestic policy.

Some argued that Obama shouldn't have attempted to reform healthcare in his first term, that he should have consolidated his power and that of the Democrats before moving. That such a view can pass for conventional wisdom in Washington tells you more about Washington and what counts as "wisdom" there. In fact, American presidents get one slender window of opportunity in the wake of their election to carry major legislation. If they don't take it when it's open, it will close forever. Again, just ask Clinton or Bush (either Bush).

Any delay on Obama's part would have been fatal to reforming healthcare and probably his presidency. The bear-wrestling that the world has just witnessed is confirmation. The grim state of the US economy would have inevitably told against the Democrats in the 2010 midterm elections. Emboldened, the Republicans would have become more hostile (if that were possible) not less, and better able to block any legislation. And anyone who thinks Obama's chances of re-election in 2012 would have been improved by putting off any attempt to reform healthcare in his first term – after campaigning so hard on the policy in 2008 – shouldn't be allowed near any campaign management roles.

The truth is that Obama did delay reform, because of the pressing issues of the stimulus bill and bail-outs, not to mention the two wars America is fighting. His real mistake was in moving too slowly. But even then he was hampered by the wait to confirm Al Franken's Senate election in Minnesota. The Democrat's filibuster-proof Senate majority only arrived with Franken in mid-July last year. And it only lasted until January and Scott Brown's election in Massachusetts. So the window Obama had was a mere six months long. And as we now know, he took it.

Still, Washington being Washington, there is a winner so there must be a loser – and the conventional wisdom will briefly anoint the Republican party as the losers last night. That would be just as wrong. The Republicans have actually done a remarkable job resurrecting themselves from political purgatory. (The Republican nadir was April last year, when Arlen Specter abandoned it.) They have rallied their party around dead-eyed opposition. Had Obama managed to pick off a few Republicans to support healthcare reform, the party could have descended into civil war. This way at least the internal peace holds, and the GOP approaches the 2010 midterms in good health. Or so it thinks.

Now what? That depends on the state of the economy. Healthcare reform is now officially yesterday's news.