Mr. Obama is also swimming against a mighty tide. Despite the passage of health reform, most Americans no longer trust the government to get things done. Obamacare is part of a bigger fight over the proper role of government that has split America in half. And even those of us who believe in universal health care might doubt the ability of bureaucrats to impose solutions to complex problems, no matter how wise and smart they are.

The new health-care legislation is a vast exercise in bureaucracy-building and social engineering, in a sector that already accounts for a mind-boggling 17 per cent of the economy. Will it produce better health outcomes? Will most Americans feel they themselves will be better off because of it? Don't bet on it.

What you can bet on is that Obamacare will fail miserably at containing costs. Americans already spend 60 per cent more money on health care per capita than we do. Yet, this legislation will do nothing to check the power of trial lawyers, unions, Big Pharma or doctors. It does nothing to check consumer demand for more and better treatments. (And if it did, Americans really would revolt.) Instead of containing costs, the legislation adds even more open-ended entitlement programs.

The official estimate says Obamacare will cost $1-trillion over the next 10 years but will actually lower federal deficits. Don't believe it. A more likely result, reckons Douglas Holtz-Eakin, a former director of the Congressional Budget Office, is that it will add at least another $562-billion to the deficit, which is already projected to reach an impressive $1.2-trillion by 2020.