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"If you are rich you have the best quality healthcare in the world, but at the same time, over 18,000 Americans die every single year because they don't have access to a doctor when they need that access."

American legislative process is based on the idea that the majority can't simply rubber stamp legislation. But in practice it means there are plenty of opportunities for opponents to jam up the process.

Half a billion dollars was spent in 2008 by lobbyists from pharmaceutical and insurance companies as well as hospitals, and doctor and nurse professional associations - the figure for 2009 is expected to exceed that amount.

From hospital emergency rooms, to congressional committees and organised rallies, Michael Goldfarb follows the progress of President Obama's mission to reform America's healthcare system.