Obama and the people behind him have moved with incredible speed to transform all of our industries and institutions into their long-awaited Marxist paradise. I think people were at first a little stunned and couldn't believe what was happening, and now they're waking up, perhaps a little late but maybe not too late.
The "health care" phase of the program is particularly important to Obama and his cadre, because it gives the government incredibly intrusive powers at an individual level that earlier, less technological dictators could only dream of. Many Americans are beginning to realize this and it is crucial for Obama to get this done before there are enough of us to prevent it.
I think the question of what he might do next is very real and very disturbing. I don't think he has his brownshirts (the various ACORN-based civilian and youth corps he proposed) quite enough organized or funded yet to be a serious threat, so I'm not quite sure where he's going to get the enforcers from. But I suspect he's working that out even as we speak.
Good point; we have to keep in mind that because this is comprehensive it will of course include mental health “care.” This is a classic way that modern socialist societies have dealt with dissidents: put them away as nuts.