I can only hope Robert Reich is wrong about the pivotal vote being left to the 216th Democrat to go along with health care reform. If it's left to one Democratic member to make the decision, and he votes no, the public will automatically assume (with good reason) he or she was bought off by Big Pharma, Big Insurance, etc.and split the payoff with other House mermbers. Democrats would fare much better if they all agreed to pass this momentous bill and took credit for it.

The media herd is suggesting by headline and sloppy reporting that there's some sleight of hand afoot in the attempt to pass health insurance reform in the House. Conspirators don't publicly announce their secret plan in advance. Clearly, a yes vote on the procedural measure will be a vote for reform. Pelosi failed to succinctly explain that House Dems don't trust the Senate to pass freestanding reconciliation legislation in order to amend the previously-passed Senate bill, but that doesn't relieve news outlets of journalistic obligations to explain the parliamentary maneuver.

To pass a $700 billion program like the Health Care Reform in the middle of the worst recession since the Great Depression, by raising taxes on the over-taxed middle class, and cutting Medicare, just as the baby boomers are aging, without cutting the COSTS of medical care and pharmaceuticals, and insuring illegal aliens is either stupid or criminal. I'm not sure which.

Nobody said that this health care bill is the last word! Its just the beginning. I think that something will be implemented eventually. I just hope that we find a way not to cut back the excise tax on Cadillac bills and we actually implement medicare cutbacks to find a way to pay for the reform. In the end I would be happy if only all the cost reduction provisions go into play. I also hope that in the future all the deals that we had to make with big pharma, medical tech, hospital chains and insurance companies gets a second look at some point in the future. This little medical migrane is not going away anytime soon but hey we get to live longer and suffer through more of this. Fun! Where are those death panels when you need them?

Some Congressional Democrats apparently believe that today's polls reflect how voters will vote in November. This would be a huge mistake. The election dynamic will change between now and November on two issues other than health care reform that favor Democrats: the draw-down on the number of troops in Iraq, and the improving economy/jobs situation. Neither issue will be completely resolved, but both are trending in the Democrats' direction, and by election time they will be able to point to success on the two most significant issues in the last Presidential election. The implication of this for health-care reform is clear: Democrats have the opportunity to demonstrate a third significant policy victory to an electorate that demanded change in the 2008 election and is even more demanding of change in 2010. The current "fears" about health-care reform will be remembered by the majority of voters as the unalterable bleatings of a hard-core minority that would never support an Obama program under any circumstances. Congressional Democrats who supported reform will run for reelection on the strength of a broad-based series of legislative victories that will demonstrate their ability to "get things done" for a change in Washington. Conversely, if they fail to pass health-care reform now, they will not only miss this opportunity, but will considerably diminish their own chances for reelection by looking like a group that had a majority but was unable to accomplish anything significant with it - they will look incompetent.

as a physician, I would like to see a cigarette tax to help pay for this. Can consider alcohol, soda, fast food as other potential tax targets.

Dr. Reich has worked the #s correctly.

Pelosi will get her way no matter how dirty she has to play or how many Dems she throws under the bus. This has become all about saving face at all costs. The upside is that the statist agenda has been kept on complete hold until well into the 2010 election year. The window of opportunity to "reform" America with additional pieces of radical legislation has been shortened considerably.

After this one-term presidency, when all threats to those who might think of betraying them are no longer applicable, the books written by those close to Obama will be in numbers never before seen. I can't wait.

I feel sorry for fellow Americans. Demagoguery of political machine, again GOP, will again win. When Obama + Clinton talked about (universal) health care insurence during the primaries, I, knowing how the system "works", said that there is no chance it will pass and if it will pass there will be so many fine print exclusions that it would be universal only in name.

Almost two years later, with badly restricted torso of proposal not having the votes in the House, when public choice, the most important aspect already missing, it seems that my prediction was - unfortunately, on mark.

When too many Americans still believe or pasively let GOP and their buddies to state that universal healthcare (yes with public choice) is "socialismus", "unamerican" etc., I have nothing more to say.

GOP and conservative Dems, who are supposedly concerned with cost control never notice or are not bothered with the fact that we spent twice as larger share of GDP on healthcare than other highly developed countries (yet in many instances we do not have even the same results to show for it). The worshiped invisible hand is, certainly in our healtcare system - clearly ineffective and extremely expensive.

With loss of (often meager) coverage due to job loss (or company bankruptcy etc.) millions of Americans are being added to the army of uninsured during this Great Recession. I wonder what it takes to have to have the "brave and free" to rise and demand for themselves and their family what the essential human need is and what all others around the world get.

So much for the opinion leaders- can it be true that we are seeing desperate congressmen resorting to any deal, any tactic, any political or parliamentary trick they can come up with to "vote for the bill" without putting their name on it.

I'd like to "deem" my bank account has a higher balance and use this to get a new car, but we all know that is silly. Our lawmakers know, in their hearts, this is not a good bill. It is complex, extremely expensive, and relies on predicting the future for the next 10 or 15 years to see "savings". In the meantime, it won't accomplish the goals of providing affordable health insurance to young americans, who will still have to subsidize older americans and get the privilege of a $12,000 federally mandated policy (they could do better now without this law). It won't fix the problem of the uninsured, if 1/3 of "uninsured" have insurance available but CHOOSE NOT to get it, why does anyone think this will change. Did we vote for a president because he promised to create 100 new federal bureaucracies to siphon more money and more jobs out of the economy to "administer" things, NO. Did we vote for more taxes for citizens and businesses, did we vote for empowering a czar to decide in 18 months what a qualified health insurance plan is, and if he or she says no, our current insurance is history, whether we "want to keep it" or not!

Yes, the democrats have a nice sized majority in the House, and so this should pass, all that is needed are more deals, more bribes, and more tactics not suitable to our democracy. If the congressmen are for this bill, let them vote for it. Americans deserve no less- we want an "up or down vote" and we want it on the real issue, not some legislative trick to "deem" this process really corrupt.

IMPEACH Obama and his comrades! They are trampling on our Constitution, destroying our health care, our economy, our future, and our country, and forcing socialism/Marxism on us through scams like Obamacare and cap and trade.

Obama and his comrades are trampling on our Constitution, destroying our health care, our economy, our future, and our country, and forcing Marxism on us through scams like Obamacare and cap and trade. The sooner we IMPEACH Obama and his comrades the easier it will be for us to protect and restore our country, our freedoms, our prosperity and our future.

Democrats are killing their Party by going with this bill. We need good reform which this is not! No lawsuit reform which is 30% of y our medical billl. We need competition across state lines which this does not include. We need to let income from prior existing conditions be tax free to the companies so they will be out looking for these folks rather than treating them like a bad sheep in the family. This is the dumbest way in the world to reform. It is deform~!! Democrats will be impossible to elect in many cities if they pass this especially if they try to ram it through illegally. It will be tied up in court for years. Pelosi has to follow democracy. She hates that but she has to do that or destroy any chance of anything happening for months. She thinks she is Evita Peron but that is just not the case and some Democrat has to volunteer to explain that to her.There is something in the water in San Francisco that destroys ones judgment cells in their brain. Till they fix that we probably should not let them vote as a part of Pelosi anti democracy push!!

November will be a bloodbath for Democrat incumbents. This will not stand.

The Democratic Leadership and the President will have to work on this very diligently and wisely to get it passed.

It's rather astounding to anyone who has thought about the issue without all the propaganda and spinning out there. The Democrats should have made it plain to all that our current system is going to crash and while it might not be for a decade we as a society have a responsibility to head off the disaster.

The system is collapsing slower than the financial system was a year ago, but it's nose down and accelerating with no hope of recovery. The costs of health care have been rising faster than the real economy has been growing for four decades, and we will at some point have to choose between health care and food or the rent as a nation -- to take care of ourselves or to sacrifice ourselves to make money.

The basic free market model of health care is that it is an out of pocket cost for all that buy it, nobody who buys it earns dividends or capital gains. For the sellers it pays their bills and gives them some money upon which to live, but no new wealth is created a long the way -- in the end health care is a cost to society which may redistribute wealth but does not create more of it. The current system enables insurers to control their risk and so maintain high enough profits to compete with the top earners on the stock exchanges. But it does so by not paying for all the care provided to all the sick. They have large numbers of healthy enrollees in group plans and they can deny anyone coverage with preexisting conditions and they can cap their lifetime reimbursements and require deductibles that are high, to restrict the risks that they must confront. Without these constraints what always happens is that healthy citizens whose health insurance is not provided as a benefit of employment are going to opt out, driving the entire heath care insurance system into insolvency when employers decide to opt out.

That is what is going to happen sometime in the next decade. The insurers are going to opt out of insuring basic care beyond annual checkups and capped catastrophic care and for elective low risk treatments by raising premiums and deductibles until nobody wants the coverage.

And that is what the Democrats needed to tell the American people but they have not. Because they have not, the opposition from the folks who think that the system as it is can continue indefinitely if it is left alone are going mad with panic.

Why does Obama attack and try to control insurance companies, while forming alliances with hospitals and doctors that let them escape major cost control? This appears strange considering insurance companies are responsible for only 4 percent of medical costs compared to 30 and 21 percent, respectively, for hospitals and doctors. This looks like a trojan horse for moving toward nationalization by first starting to take over control of the payments, while letting the hospitals and doctors continue to gouge consumers, and then restricting these payments later.

The most depressing aspect of this entire matter is the disappearance into the clutter of the most fundamental factors of all: 1. We pay more per capita than any other society for health care and rank down in the mid-thirties in results, 2. American business is at a competitive disadvantage so long as it is burdened with providing health insurance to workers, and 3. There are so many good models out there to emulate but this society is organically incapable of learning from others or our own mistakes.
Carl, Portland

This is a historic moment in the history of our country. Health care reform must be passed. We had these same political divisions during the voting rights, civil rights,social security and medicare debates in the country. Where would we be had those legislators failed the country.

Democrats who deny passage of the bill will definately not return after November and forever be a "Jeopardy Game" category. They will have the same status in history of John Wilkes Booth.

the die is cast: the Democrats must cross the Rubicon! And we'll all be better for it. At long last a political party and a determined president will have shown tne resolve to get something beneficial done. Amen

FOLKS Please Remember:

OBAMA is trying to get us to buy Health Insurance.
HEALTH INSURANCE is not HEALTH CARE !!!!!!!

Please understand. Health Insurance companies want to profit from
your illnesses, not take risks...

Health Care is about delivery of medical services. A good way to give
out nation Health Care would be to simply expand existing VA Veteran's
Administration Hospitals and Clinics.

Let OUR taxes be spent on OUR Health Care Delivery System.
Not on Forced Purchase of Health Insurance Policies with Jacked Up Prices.

Maybe we could trim the Military Industrial Complex budget to pay for it...

The bill is a sellout to the insurance companies (who should be eliminated from the equation) but is better than the status quo.

We need to hold Obama's feet to the fire for being corrupted by big pharma and the insurance companies and failing in almost all his campaign "promises" to the American people.

Shame on me for trusting ANY politician.

@Ocean Blue (#3): First off, we all have to understand that the lack of proper access to healthcare, the exponentially rising costs within healtcare services and the equally rising costs of insurance are all directly connected to the problems we face within this economic recession. The timing of this is essential. To suggest we put it off until we are no longer in recession is missing so many of the key points of reform. If healthcare truly is 1/6th of our GDP (and growing) then we would be remiss to ignore it during the recession. Also, on the job creation front, business owners are less likely now to hire new full-time employees without being able to project what their healthcare benefit costs will be. Once we put a limit on how the insurers are able to raise their rates this will become easier for employers to predict and will help our employment numbers.

Second, suggesting that taxes will be raised primarily on the middle-class is a complete distortion of the actual provisions of the bill. The provisions make sure that people in the highest income brackets or with the highest amounts of privilege across the healthcare spectrum are paying their fare share of the universal medical costs that we all pay for out of each of our paychecks. Middle-classed people would not see any increases of that nature (unless you define middle-class the way John McCain did during the campaign). Please, stop spreading this misinformation.

Congress:
A)Do whatever is necessary to make this bill law. Even with all its faults it will be a godsend to tens of millions of people.
B) Get to work on improving it. We deserve better.

This entire process will have a devastating effect on the legislative process in the future. The sheer magnitude of manipulation is beyond the scope of anything I have ever seen in my lifetime, and I am nearly 60. While the majority of Americans feel health reform is necessary, not a single poll over the past six months or more has shown that Americans want this bill to pass, (and by much larger margins than elected this president to office). Democrats are foolish, period. This has been a despicable process throughout and we still don't know what is contained in this bill and will likely not know for many, many years. The repercussions of passage will be deep and wide, and the ability of either party to effectively govern will be changed forever. This is just astonishing and I find this whole process dishonest to its core. The American people will suffer if this bill passes. I will never again believe or support anything this president says. I have listened to all the rhetoric and read everything I possibly could on this topic. He is simply lying to us to impose his agenda. My support for Congress went away a long time ago.

@Bob in Texas: Several years ago Texas enacted tort reform for medical malpractice cases. Have you seen a 30% reduction in health care costs in Texas since then?

.......

No? I didn't think so.