The House came through for President Obama in his drive for health care reform, but that may be the last piece of good news on the subject that the president has for quite a while.

Even though the vote on the House bill, H.R. 3962, was a squeaker, passing only by a 220-215 tally, it was still a historic moment.  Yet, that is hardly the kind of momentum necessary to spur any kind of fast action in the Senate that the president wants.  

It was a nail-biter in the House right until the vote on Saturday evening, Nov. 7, with a flurry of compromises being made during the day, particularly on the issue of coverage for abortion.  In the end, the Democrats managed to siphon off one Republican vote, a representative from Louisiana.  Thirty-nine Democrats voted against it.

While there was a lot of high-fiving and cheering among the House Democratic leadership, particularly among those members who have been carrying the torch for universal health coverage for years if not decades, the White House is starkly aware that this fight is nowhere near over. 

The reality is that the finished product—if there is one—is going to look very little like the House bill.  The components of the Senate bills that Sen. Harry Reid is trying to conflate into one bill are already vastly different than the House bill. 

Then Reid is going to have the problem of getting the 60 votes necessary to even bring the bill to the Senate floor.  If and when it reaches the floor, the debate and chance for offering amendments are pretty much open-ended.

At this point I’d say that having a bill on President Obama’s desk by Christmas looks a lot more like wishful thinking than something that is likely to happen.   

But then, Virginia, it is the Senate and it is Washington we’re dealing with, after all, so you never know.

Who knew that health care reform was so hot a potato, so radioactive a subject, so visceral an issue that it would be the impetus for congressmen being hanged in effigy, getting death threats and being shouted down by angry mobs in town hall meetings around the country during August?

Yes, sir, there’s nothing like American mobocracy in action.  You just try to touch my health insurance, sonny, and I’ll blow your head off!

I have some advice for any congressman still courageous enough to face wrathful constituents (or those people who are not constituents but decided to drive in for the fun): If before entering the town hall meeting premises you see at the entrance a middle-aged woman sitting in a chair and knitting, inform your staff that a sudden attack of stomach cramps has left you unable to go on with the event live, but you’ll be happy to participate via teleconference from a neighboring town.  

It strikes me that it would be refreshing to actually talk about the need for health care reform, the various mechanisms that have been proposed for getting there, or how our society is going to sustain the ever-increasing costs of the current system if reform is not forthcoming. 

For certainly, if anything merits serious discussion, making changes to a business that is the equivalent of one-sixth of the GDP (at least this week) is that topic.

And maybe that’s why whatever the shouting’s about it’s not really about health care reform.   

I know there are lots of people out there who hate the government, especially the federal government. And I know this because I get withering letters and emails from a lot of them regarding this column and my blog!

What astonishes me (and to be totally truthful, frightens me too) is the intensity of the anger and bitterness that a wide swath of people in this country apparently feel regarding the perceived sins of the federal government.   I just don’t get it. 

Would they really fold up Medicare and send droves of seniors back to living at or below the poverty level?  Would they jettison Social Security?  Kill off Medicaid because after all it’s the poor that benefit from it?  Is it really OK that 47 million people in this country are uninsured?

However, to give this crowd the benefit of the doubt, maybe they really do feel as if this is the time and place and issue where they have to make a last stand.  After all, if the government takes over health care, what’s left?

There is hardly anything more seductive for people addicted to last stands than the glory that comes from making them. 

The downside to this glory is that there is no talking to people so addicted.  You can’t tell them the government, meaning the Obama administration in this case, doesn’t want to take over the health care system.  In their eyes, that’s just a load of you know what.

But, seriously, how have we gotten to the point where the administration is being slammed as having Hitler-like plans for the country? Where accusations of “death panels” hidden in legislation are created out of whole cloth and given life and credibility by media addicted to fanning the flames of controversy, no matter how spurious?

Maybe it’s all just politics as usual and the whole point is to ensure that health care reform will be President Obama’s “Waterloo,” as Sen. Jim DeMint put it.

If that’s the case, then there’s something far sicker than our health care system that needs attending to.

One of the things that makes life really interesting (sometimes a little too interesting) is when expectations are upended.

So, who would have guessed that Iowa would be the third state to legalize marriage between persons of the same sex?  And that barely a week later Vermont would follow suit.

The first was my beloved Massachusetts.  But that was not really a surprise since many people (especially those who don’t know it), think the state is totally whacked anyway.  Then came Connecticut.  But that’s probably just the ruboff factor from being next to Massachusetts.

California (now there’s no surprise) was next in legalizing so-called gay marriage, but this was overturned in November when the Mormons allegedly went all out and financed an electoral push that rejected it.

Now there’s Iowa. And Vermont. My goodness, as Aunt Polly used to say as she stood on the porch watching the cows come back from the pasture, isn’t this a turn of events?

How this came about in the Hawkeye State is that the Iowa Supreme Court upheld a lower court ruling from a couple of years ago that overturned a state law that restricted civil marriage to the joining of a man and a woman.

Just as startling as the upholding itself was the fact that the 7-person Supreme Court was unanimous in handing down its decision. 

According to the New York Times, Justice Mark Cady, a Republican appointee, wrote, “We are firmly convinced the exclusion of gay and lesbian people from the institution of civil marriage does not substantially further an important governmental objective.  The legislature has excluded a historically disfavored class of persons from a supremely important civil institution without a constitutionally sufficient justification.”

Vermont is probably less of a surprise. Time was it used to be considered a pretty conservative state, although not as conservative as its next-door neighbor, New Hampshire. But Vermont has moved steadily to the left.  For years it was represented in the House by Bernie Sanders, who calls himself a democratic socialist.  (And imagine, despite that he kept getting elected over and over again!  And not only that, he’s now a U.S. senator from the Green Mountain State.) 

Will wonders never cease, as Aunt Polly used to say, as she went out in the morning to get some maple syrup for pancakes.

Why is this important to the life insurance business?  Duh, it’s Iowa, not exactly the first state that springs to mind as a hotbed of radicalism.

And yet, and yet.  (Maybe that should be the motto of my blog, which you can check out at www.lifeandhealtheditor.com).

And yet, in some instances, the state has been in the vanguard in fighting for social justice and has sometimes been considered a bellwether for the rest of the country. 

So the business should take notice of what happened in Iowa as an early marker of how the future is likely to unfold in regard to this issue.  Not tomorrow, obviously.  But eventually.

The U.S. is changing, not only demographically, but also in how a big swath of the population looks at-and recreates in a new guise–age-old situations like marriage and family.

The fact that Iowa is in the so-called heartland of the country goes right to the heart of the matter.