In an historic vote, the United States House of Representatives has passed a bill that will radically reform the country's health care system. The bill was passed late on Sunday by 219 votes to 212. Every Republican representative, as well as 34 Democrats, opposed it.

The vote represents a significant political victory for President Barack Obama, who campaigned for election on a pledge to help every US citizen obtain health insurance. At present, an estimated 32 million US citizens do not have health insurance, even though more money is spent in the US on health care than in any other Western country.

The bill bans the denial of health care for pre-existing medical conditions, provides subsidies to buy private insurance in newly-created marketplaces called 'exchanges' and expands the government-run Medicaid programme for the needy. It represents the biggest change to the country's health system since the introduction of Medicare, the government-run scheme for Americans aged 65 or over, in the 1960s.

The version of the bill passed on Sunday was approved by the US Senate in December. However, it differed from that originally approved by the House of Representatives in November. Therefore, after passing the bill, the House then approved the changes. The Senate must now approve these changes before President Obama can sign the bill into law. It is expected to do so later this week.

However, Republicans, who say the bill is too expensive and fear it will increase state interference in health care, have already announced their intention to continue the fight against it in the Senate.
 
Mr Obama cancelled a trip to Indonesia so he could make a final appeal to undecided Democrats to vote in favour of the bill. In a passionate last-ditch attempt to persuade wavering Democrats to support it, the president begged, "If you don't do it for me, do it for the American people." He won support from a group of conservative Democrats by reaffirming a longstanding US ban on government funding for abortions.

After the bill passed, Mr Obama thanked the House of Representatives and called the result a victory for the American people and for common sense.

Nancy Pelosi's final floor speech for the health care reform bill: