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THE House of Representatives narrowly passed a health-care bill on Saturday November 7th, a big step for those who want to reform America's $2.5 trillion health-care system. Barack Obama spent part of his Saturday making a rare visit to Capitol Hill to press some hesitating Democrats into giving their support, although in the end the tally of 220-215 in favour of the legislation, with 39 Democrats voting against, was a tight margin. The bill picked up the support of just one Republican, Joseph Cao, a first-term congressman from New Orleans who faces a tough battle for re-election next year. After securing the lone Republican's support, Steny Hoyer, the Democrats' majority leader, jokingly declared that there had been “a bipartisan vote”.