The health reform debate can be bewildering, with thousands of pages of legislation and mind-numbing complexity of parliamentary procedures. But none of that matters now.

The Congress is just one vote away from passing legislation that would put one sixth of our economy under permanent government control.

How can that be when this legislation is so overwhelmingly disapproved by the American people?

President Obama and his congressional allies are meeting with House Democrats to convince them to vote for the Senate bill "to just keep the process moving."

But if the House passes the Senate bill with a simple majority of 217 votes, ObamaCare becomes the law of the land. Nothing else matters. The Senate may, or may not, pass a second bill to "fix" problems the House has with their provisions. It matters not.

It would be the dupe of all time if House members were to be convinced that they must go first to keep the process moving forward, only to find that ObamaCare has passed the finish line. If the House passes legislation identical to the Senate bill, the president signs it, and it becomes law.

That means House Democrats will be on the hook for a vote for:

• The Cornhusker Kickback, the Louisiana Purchase, and every other vote-buying deal buried in the Senate bill.
• Abortion language that clearly allows federal funding for abortion and which the U.S. Conference of Bishops solidly opposes.
• The Cadillac tax on high-cost health insurance policies that labor unions hate.
• Weak enforcement provisions for the individual mandate that health insurers say will cause pools to disintegrate, causing premiums to skyrocket for those still buying policies.

If the House complies, and Speaker Pelosi is close to having the needed votes, then President Obama would sign his comprehensive health reform plan in the form of the Senate bill the next day, and the job would be done. Any promises that it would be fixed later on aren't worth the paper they might, or might not, be written on.

This is the end game. The White House is going for broke on ObamaCare.

Published on Medical Progress Today's Second Opinion, March 5, 2010.

The health reform debate can be bewildering, with thousands of pages of legislation and mind-numbing complexity of parliamentary procedures. But none of that matters now.

The Congress is just one vote away from passing legislation that would put one sixth of our economy under permanent government control.

How can that be when this legislation is so overwhelmingly disapproved by the American people?

President Obama and his congressional allies are meeting with House Democrats to convince them to vote for the Senate bill "to just keep the process moving."

But if the House passes the Senate bill with a simple majority of 217 votes, ObamaCare becomes the law of the land. Nothing else matters. The Senate may, or may not, pass a second bill to "fix" problems the House has with their provisions. It matters not.

It would be the dupe of all time if House members were to be convinced that they must go first to keep the process moving forward, only to find that ObamaCare has passed the finish line. If the House passes legislation identical to the Senate bill, the president signs it, and it becomes law.

That means House Democrats will be on the hook for a vote for:

• The Cornhusker Kickback, the Louisiana Purchase, and every other vote-buying deal buried in the Senate bill.
• Abortion language that clearly allows federal funding for abortion and which the U.S. Conference of Bishops solidly opposes.
• The Cadillac tax on high-cost health insurance policies that labor unions hate.
• Weak enforcement provisions for the individual mandate that health insurers say will cause pools to disintegrate, causing premiums to skyrocket for those still buying policies.

If the House complies, and Speaker Pelosi is close to having the needed votes, then President Obama would sign his comprehensive health reform plan in the form of the Senate bill the next day, and the job would be done. Any promises that it would be fixed later on aren't worth the paper they might, or might not, be written on.

This is the end game. The White House is going for broke on ObamaCare.

Published on Medical Progress Today's Second Opinion, March 5, 2010.