Last updated: 21 january, 2011 - 14:32 GMT  The Americas  Health
of a Nation  Doctors performing an operation   Play in either
Real OR Windows Media players  "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.       • Factors
affecting healthcare refor