After months of debate, you might expect the outlines of a law to transform US healthcare to be clearer. If only. Already exhausted by endless to and fro on the question, US voters now long for clarity above all. Congress is not listening. Nor, apparently, is the White House. Confusion and posturing reign and the possibility of consensus seems as remote as ever.

After seeming to inch away from the contentious “public option” – a proposed government-run insurance plan, which would compete alongside private plans – Democratic party leaders in the House and the Senate have declared their intention to press for a bill that includes it. This unsettles even moderates on their own side, and makes passage of a bill in the Senate, where every non-Republican vote will be needed to overcome a filibuster, quite a challenge.