Any health care bill, I suppose, is better than none — and any small amount of courage displayed by Democrats is a lot better than the total lack of balls they displayed up to this point. It's a shame that by enshrining private insurance in the law, Congress probably has permanently blocked the possibility of a Canadian style, single payer system.
It was nice, though, to see the president finally step down from his pedestal of aloof, superior non-confrontation and twist a few arms. If he'd been willing to do that from the beginning, we might have ended up with a better law — not much better, of course, because in a corporatist plutocracy the interests of corporate plutocrats always must come first — but possibly a law that provided for a public option, at least, and provision for nationwide insurance exchanges instead of a vague mandate that they be established by the individual states.
Personally, I don't think the passage of the law will hurt the Democrats at all in the next cycle of elections — Americans like winners, and the Democrats won this one. If they go on to push through some substantive financial reform, unperturbed by irate Republicans jumping up and down like Yosemite Sam (and the occasional death threat), they can demonstrate the kind of strength Americans genuinely admire.
How successful they can be depends, to a great extent, on Obama. Health care shows us that if he provides real, aggressive leadership, things can get done — and Republicans have been behaving like such assholes of late, even Fox is having a hard time making them look good. (Fox also must bear quite a bit of the responsibility for unleashing the crazies, including the militias and neo-Nazis as well as the dopes in the tricornered hats.)
Speaking of crazies and death threats, I seem to recall that the assassination attempt on Ronald Reagan didn't hurt him at all, politically. It's wishful thinking, but I think a failed assassin who says his attempt on Obama's life was inspired by Glenn Beck would be just about perfect.