The Democrats are divided into three groups. You have the establishment types who want to pass anything in order to tell their constituents that they are changing the country. You have the moderates who want to pass something, but want to make sure the final product isn't too expensive or too liberal. And you have the Netroots, the most vocal and energetic force in the Democratic party, who have arrived at the conclusion that the Democratic leadership has sold them out. Uniting these three camps requires a legislator with skill, cunning, and strong leadership. Nancy Pelosi, who has all three attributes, did her job. Harry Reid? He's working on it.
The only problem with this analysis is Pelosi only got 50.5 percent of the House to vote for reform and Reid needs 60 percent of the Senate.