The House of Representatives debate on the health insurance "reform" is over with the Democrats failing the people and the Republicans disgracing themselves as having left their minds back in the third grade (with apologies to third graders).

House Democrats were determined to pass any bill with a nice sounding name, such as "The Affordable Health Care for America Act". Single payer, full Medicare for all was never on the table even though a majority of citizens, physicians and nurses support that far more efficient, free choice of health care professionals, system.

There are no effective cost containment or prevention measures in the bill. The public option is so weak it will be a receptacle for the sickest of patients among the meager number of people who qualify for its coverage. There are no provisions to reduce the number of people (100,000) who die annually from medical malpractice in hospitals.

Nor is there a major program to reduce the tens of billions of dollars that is stolen yearly out of Medicare from criminals inside and outside the medical profession.

The cover story in the November issue of the AARP Bulletin is on the elaborate but detectable schemes to swindle Medicare with phantom services, phony rentals of equipment, stolen Medicare numbers and the like. The author, Jay Weaver, writes: "So lucrative, and so low-risk, the FBI reports, that a number of cocaine dealers in Florida and California have switched from illicit drugs to Medicare fraud."

Although more money is finally going for prosecutions, there is nowhere near enough for this corporate crime wave. Medicare's office of Inspector General asserts that every dollar of law enforcement will save $17 of theft.

Computerized billing fraud and abuse takes anywhere from $250 billion to double that estimate by the General Accounting Office. (The GAO said ten percent of health care expenditures are going down the drain.) The reason why the estimates cover such a broad range, according to Professor Malcolm Sparrow of Harvard University, is that there are inadequate resources to document the huge hemorrhaging of the nation's health care budget and come up with better data.

Apart from the impoverishment of the debate, there is the actual doing of harm. The bill, if enacted, doesn't take effect until after the presidential elections in 2013, mostly to let the drug and health insurance industries adjust, though they can scarcely believe their good fortune at being delivered all those profitable customers paid for by taxpayers with scarcely any price restraints.

The Journal of Public Health has just published a peer-reviewed study by Harvard physicians-researchers that estimates 45,000 Americans lose their lives yearly because they cannot afford health insurance to receive diagnosis and treatment. Strange how cool the House is to giving these fatalities a four year pass.

Congressman Dennis Kucinich (D-OH), a leading single payer advocate, voted against this legislation for many reasons, most notably the Obama-driven omission of his amendment to clear the way legally for states to pass their own single payer laws. Several states, such as Pennsylvania, are in the process of moving legislation in this direction, but are concerned that the health insurers will claim federal pre-emption.

The victims of medical malpractice - estimated by the Institute of Medicine and the Harvard School of Public Health to be about 100,000 deaths a year - escaped having to overcome more hurdles before they have their full day in court. Helping to beat back the Republicans, who define "medical malpractice reform" as letting the negligent perpetrators get away with their lethal consequences, was Congressman Bruce Braley (D-IA).

Rising on the House floor he delivered a factual plea for patient safety. Hardly had he started to speak with Republicans started shouting "trial lawyer, trial lawyer" referring to his previous profession of representing wrongfully injured people before local juries in Iowa. This rare display of shouting by opponents was punctuated by one of their unleashed members rushing down the aisle shouting "You'll pay for this."

During this overall debate on the bill, Republicans stood up one by one, as prevaricatory dittoheads, to often scream and howl (like coyotes) that this is "a government takeover of one sixth of the economy," "would destroy the economy," "put 5.5 million people out of work," "destroy the doctor-patient relationship," "be a steamroller of socialism," "force millions of seniors to lose their current health coverage" (meaning, Medicare?) and, in a passionate appeal to the Almighty, Congressman John Fleming (R-LA) declared "God help us as the government takes over your day-to-day life."

Never mind that this bill is just an expansion, however misdirected, of government health insurance designed to increase corporate profits and increase the corporate grip over the day-to-day decisions regarding who, when and how people get their health care or get their bills paid.

To top off the madness, Senator Joe Lieberman (I-CT), an ever maturing political hermaphrodite, reneged on his assurance to Senate Majority Leader Harry Reid and imperiously announced on Fox News Sunday that "if the public option plan is in there, as a matter of conscience, I will not allow this bill to come to a final vote."

For media-centric Joe, his motto seems to be "L'Senat c'est moi."

Ralph Nader is a consumer advocate, lawyer, and author. His most recent book - and first novel - is, Only The Super-Rich Can Save Us. His most recent work of non-fiction is The Seventeen Traditions.

more Ralph Nader