I was rather surprised to see the number of Democrats who supported the amendment. I suspect that by allowing the vote on the Stupak Amendment, House Speaker, Nancy Pelosi assured passage of the overall bill.

The second issue leading up to the final bill was debate on the Republican substitute for the Democratic proposal. While there may have been some good provisions which are worthy of an up or down vote in the future, the entire Republican legislative effort since the Congress was sworn in has been simply obstructionist. How can Republicans expect to to be taken seriously when they propose a substitute bill less than a week before a final vote is scheduled? How can they expect to be credible when the Minority Leader, Rep. John Boehner, spoke to a rally of anti-government fanatics among which included extremists carrying an enormous sign with a photograph of Nazi concentration camp mass burial trenches?

Elections have consequences! The Democrats won a majority of seats in the House and Senate along with the presidency. A fair view of last year's outcome could rest on a considered decision of the electorate as to which candidates and parties offered the better ideas on health care.

Now, I haven't read the entire bill but I did read the official summary (on line at www.house.gov) and, having listened to the debate, (even as poorly conducted in the media as it has been) have come to the conclusion that the bill should not be enacted in its present form (big surprise, no?). I'm actually surprised that the present bill doesn't contain more earmarks and lobbyist silliness but, hopefully, most of the fluff will be stripped out in conference should the Senate pass a bill.

I remain convinced that the ideas I expressed during my campaign for Congress in 2008 remain a far better solution the current House or Senate committee bills (and what is likely to remain after conference) for reforming health care. In short, the government should offer a bare bones insurance plan (or a modified catastrophic injury plan along with increased health savings accounts) with a focus on preventative care and wellness. An enrollment mandate and broad-based tax on all individuals to obtain such insurance would provide the underlying funding mechanisms. Most people and employers wouldn't want to join this public option because it wouldn't provide much optional coverage and the reimbursement rates to doctors and hospitals would be minimal in exchange for reductions in student loan debt for doctors and nurses. It would also permit the government to negotiate for lower drug costs from manufactures and permit individuals to obtain drugs from overseas. What it would help to do is keep cost shifting from the uninsured to those with current coverage. Of course, the best way to control costs is to have healthier Americans. That ought to be the overriding focus in any plan. But, we should also recognize that the best way to have healthy citizens is to encourage them (liberals would call it empowerment - conservatives would label it personal responsibility) to make healthy choices. A natural consequence of this focus would impact the oft stated bipartisan desire to have insurance cover pre-existing conditions. Accordingly, those who make healthier choices ought to be rewarded with lower premiums.

In closing, I want to ask the readers to keep in mind that all this hoopla over the summer and the fall (e.g., the tea baggers, and town hall disrupters) shouldn't distract us from demanding that Washington evaluate all our domestic policy choices with the overriding priority of focusing on funding the successful (the definition of which is subjective to be sure) outcome of the wars in Afghanistan and Iraq which is one of the primary reasons (along with the Bush 43 first term tax cuts for the wealthy) for the exploding deficit which has served as a primary rallying cry for those who oppose the government's attempts to reform health care.