What just happened over the last month?
Here's a recap. Marginal Members of Congress knew that health care reform was going to be under attack in August. Since it wasn't possible to pass a bill into law before August recess, they much preferred a situation in which they could defend the concept of health care reform, but not the details of any particular bill they had voted for. So the vote was delayed in the House. Meanwhile, in the Senate, marginal Democrats deprived of the possibility of Republican votes as political cover chose to substitute bipartisan negotiations as concrete evidence that these marginal Democrats were not acting like crazed left-wingers. "Negotiations" had nothing to do with finding a compromise between Democrats and mainstream Republicans, since everyone knows that the mainstream of the Republican party is following a pure rejectionist strategy. However, the rules of the game say that scorekeepers can only report that Republicans have rejected compromise if they actually do reject compromise, and therefore it was necessary to "negotiate" until Republican "negotiators" admitted that they were not, in fact, negotiating in good faith.
All of this played out nicely for the Democrats. As expected, opponents of reform attacked, but as far as I can see the attacks produced very little -- they convinced the national press that Republicans had little regard for the truth, and by attacking phony provisions or wildly exaggerated minor provisions, opponents made it easy for Democrats to denounce the (non-existent) problems with the bill, leaving the major provisions essentially unchallenged. Since Congressional Democrats had wisely avoided voting on a bill before recess, they were not (and will not be) subject to attacks based on claims that they voted for whatever nonsense was supposedly in the committee drafts. It could have been worse; opponents could have targeted key provisions of reform, but mostly that did not happen. Also, the "negotiations" played out well for the Democrats, as Republican "negotiators" did, in fact, admit that they were not negotiating in good faith before Democrats needed to move ahead with the bill once recess ended.
We reach the end of recess with every single Democrat in the Senate still publicly open to pretty substantial reform; the most conservative Democrat, Nelson of Nebraska, went on record supporting a compromise on the (politically) most difficult provision at this point, the public plan. There appears to be one solid vote for reform on the Republican side (Snowe), and perhaps one to three other possibilities -- one solid loss for reform was the surprise resignation of a fourth possible vote, Mel Martinez (there's no chance that Christ's hand-picked replacement will do anything to endanger Christ in his upcoming Senate primary). Democrats will have to forge a compromise between liberals and moderates, but at least as I see it there are no obvious deal-breakers; liberal threats to sink any compromise are surely bluffs, albeit the correct play at this point. The bill won't be everything liberals want (although that's mostly a consequence of the presidential nomination battle last year, in which no candidate advocating single-payer drew any support), but it will be a major substantive bill.
One more thing: I still think there's around a 50/50 chance that the end-of-life counseling stuff will be stuck back in before all is said and done.