And, if the bill passes, then what? The howls of protest from the elderly the first time they are denied health care will be something to behold. It will become evident that immigrants -- legal and not -- are being given the health care now reserved for the elderly, and the anger will be enormous and instant.

Most Americans are not sick and don't use medical facilities frequently. But the elderly are in constant touch with their doctors and medical providers. The curtailment of that access will become immediately apparent -- in more than enough time for the 2010 elections.

There are some votes that live on and on. They don't go away. People remember. From the time Bush Sr. passed the Kuwait resolution for military action against Saddam Hussein until Bush Jr.'s Iraq War began to go south in 2004, the gold standard for an appropriate attitude on national defense and security policy was how one voted on the Kuwait war resolution.

Clinton chose Al Gore for his ticket in 1992 largely based on his vote in favor of the invasion. It sent a signal that Gore and he were "new kinds of Democrats." This health care vote is a matter of similar consequence, and the impact of this vote will last long and linger for years.