This Health Care Reform Bill is going to be the defining element of the Obama Presidency. If he fails to get it passed, he will go down in flames - which he just might regardless depending on what the economy does as a result of the huge stimulus money being spent with little or no meaningful results. The cost of the Health Care Reform bill is going to come heavily into play because I think most Americans don't want to spend this kind of money at a time when the economy is not anything near "good". How Obama comes up with the money to pay for it will be a key to the bill's passage. Now, if this Health Care Reform bill gets passed with the current publics very low opinion of it, there will be a large number of unemployed Democrat Congressmembers come the next election. The House most likely will change over to Republican control and that will also be Obama's defining moment. The absolute best thing he could do, politically, is to call a TIME OUT, and carry this ball into the locker room to have it well-discussed and come back out to the field with a better game plan. Under it's current form, economic situation of the nation, public opinion considered, and Congressional support, I think Obama looses the game 21 - 20 in overtime.
On the contrary, if no health care initiative gets passed after all this, costs from the private sector will continue to rise and the same grumbling will occur next year and beyond. What will happen is more and more people looking at people like you and saying we told you so...
Clinton took a hammering in the early months of his first term over health care, and the polls (like Obama) had everyone predicting Clinton's early demise, but he went on to do other controversial things, ultimately leaving office with an approval rating of over 60% in spite of the Lewinsky scandal.
Nothing is as predictable as you would like. All you can do is wish. Frankly, I might half-way agree with you if the Republicans had a decent candidate that could bring the party back together. But it's fractured, has no platform, and needs at least another full election cycle before the GOP earns back its credibility.