I see the next few years as a critical passage for America's experiment with democracy. The Republican Party is being pulled further toward absolutist perspectives by Tea Party members. The election of a President Sarah Palin in 2012 is a real possibility. Her "death squads" references (as related to healthcare policy) hit a chord among many people.
Around the world we see examples of people in Western Democracies assuming a childish perspective that government can and will make life easy. Reality is not simple and political leaders have limited abilities to, "make it better," like mommy kissing a hurt. At some point, fiscal conservatism is going to run headlong into social conservatism. Medical realities demand difficult choices. It is not possible to maximize quality, accessibility and affordability all together. I am concerned that the nature of political discourse in the United States in the near future is going to strain the fabric of democracy.