By early November the US Senate and the House of Representatives are likely to have pulled together several different bills on healthcare reform and to have begun debating them.

There are five bills, three in the House of Representatives and two in the Senate. Committees are working to come up with a single bill for each chamber. The House and the Senate bills may differ.

The House and Senate will then debate each bill, propose amendments, and vote. After that a House and Senate conference committee will reconcile the bills, both House and Senate will vote on the final bill, and then send it to Barack Obama to sign or veto.

In the House, the bill can be passed by a simple majority, and Democrats have a large majority. In the Senate it will need 60 of the 100 senators to vote in favour, and that may be close. There are only 60 Democrats or those who vote with them in the Senate. Democrats in the House and Senate disagree among themselves about the proposed reforms (www.washingtonpost.com, 17 Oct 2009, “House, Senate Dems at odds over health care overhaul”).

Tom Harkin, senator and Iowa Democrat, told the Bloomberg news service that he expected the Senate bill to be finished before …