As speeches droned on in a half- deserted chamber, the prospect of real reform this session was shrivelling. The best chance of resuscitating what was to have been the centrepiece of President Bill Clinton's political programme now lies in yet another revamp of the measure, to win over an emerging group of Democrat and Republican moderates. Even so, the chances of success look slim.
A summer recess that should have started last weekend will now be delayed for a fortnight at least, and tempers are wearing thin. For most of yesterday, Republicans continued their stalling, with long floor speeches designed to waste as much time as possible. The one gleam of hope was the frantic backstage efforts to meld the watered down bill of Senate Majority leader George Mitchell now under debate, with even less ambitious proposals from the new bipartisan 'Mainstream' bloc of centrists from both parties. But one 'Mainstream' Republican said the group was still 'light years' from the Mitchell draft.
Even among themselves, Democrats are deeply divided. If Mr Mitchell makes further concessions, he risks losing the backing of liberals who insist on broad- based reform and a clear timetable for universal coverage. Further confusing matters are separate plans for a minimalist version of the bill, confined to changes in insurance that would lower rates and make it harder for insurers to refuse coverage to individuals with pre-existing conditions.
Part of the problem lies in the laxer rules of the Senate, which require a 60-40 majority to push through a guillotine motion to cut off debate. Alas for Mr Mitchell, there are only 56 Democratic Senators. Republicans, always the more disciplined party, can mount filibusters to veto any controversial legislation they choose.
Anxious to avoid blame for health reform's demise, Republicans piously maintain that Healthcare is too important and complex an issue to rush. Far better to wait until next session - by which time, mid-term elections may have given Republicans outright control of the Senate. But on Monday evening, even the long- suffering Mr Mitchell's patience ran out. The Senate had the choice of starting to vote last night, or remaining in continuous session indefinitely.
At the other end of Capitol Hill, the adminstration was desperately seeking to salvage its other main legislative goal, the crime bill which the House torpedoed last Thursday. Its arithmetic is less complicated than health care, but its politics, perhaps more so.
After the 225-210 vote defeat, in which 58 Democrats voted against him, the President must persuade at least eight Congressmen to change their minds. Last night White House officials were confident they could pull it off, as Mr Clinton personally lobbied members of the House black caucus, and Chief of Staff Leon Panetta went to Capitol Hill to tackle other Democratic waverers.
The White House hopes to hold a fresh vote tomorrow and after days of emotional invective against Republicans and the National Rifle Association, Mr Clinton signalled a readiness to compromise on the dollars 33bn ( pounds 22bn) measure. But he insists the final bill must include the ban on 19 types of assault weapons which is anathema to the NRA, the 'three strikes and you're out' provision for criminals, and money for 100,000 more police. But he may have to abandon some of the socially-orientated provisions of the bill - such as the 'midnight basketball' funding which hardline Republicans love to mock.