Paul Greenberg

It's got to be about the oldest dodge in the book: When a politician casts a momentous vote on a major issue, and doesn't want to take responsibility for it, the pol minimizes its importance. The folks back home are told it was just a little ol' procedural vote, and they needn't worry their pretty little heads about it.

Blanche Lincoln, the senior senator from Arkansas, has got this routine down pat. When the showdown on the health-care bill came Saturday night, she cast the deciding 60th vote to cut off debate on whether to let this huge hodgepodge of a bill advance to the floor of the Senate. It could prove the most significant vote of her otherwise unremarkable political career.

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Once debate on whether to proceed with this ever-morphing blob of a bill is cut off, as it now has been, the Democratic majority in the Senate won't necessarily need a super-majority of 60 votes to pass it. A bare majority of 51 would suffice, although another procedural hurdle could quite likely require the Democrats to muster another 60 votes in the Senate to make the most radical change in the nation's health-care system in decades. And it will be Blanche Lincoln's vote that made it all possible. Much as she might try to deny it.

The senator says she's against a public option -- that is, a government-run insurance scheme with all its dangers to private insurers, and to workers who could be dumped into it by employers unwilling to go on paying their employees' insurance. Yet it may be Blanche Lincoln's vote that opens the way for just such a drastic change.

Despite all our president's glib assurances, Gentle Reader, few things might remain the same about your health insurance once such a bill becomes law. And that includes your choice of doctors and treatments, your Medicare or Medicaid or private health insurance, or anything else to do with your health care. The changes may be put off for a few years, but changes there would be. Big ones.

Then there are all the taxes, fines, subsidies and other complications such a bill could rain down on the American economy. That's no small thing, for the health-care industry represents a sixth of that economy. And all these changes would come when the country needs stability and steady growth, not more drama and uncertainty. The message of Saturday night's vote in the Senate: Tighten your seats belts, folks. This could be a bumpy ride.

Paul Greenberg

Pulitzer Prize-winning Paul Greenberg, one of the most respected and honored commentators in America, is the editorial page editor of the Arkansas Democrat-Gazette.