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As I was watching the vote from the Senate Gallery at the crack of dawn Tuesday morning it became clear to me that this health care bill needs to pass. Republicans are carping about voting on Christmas Eve. Fortunately they decided not to hold the Senate in session until late in the evening.

The GOP has painted it as the Democrats "ramming" through health care. Senator Tom Coburn said " What the American people ought to pray is that somebody can't make the vote tonight. That's what they ought to pray." With Senator Byrd ailing, the Democrats are not taking any chances and are still wooing some possible Republicans. Senator Olympia Snowe met with President Obama recently and is still working with the Democrats but the pressure from her own party to vote health care down is enormous.

I am one of the people who believe that health care is a right and not a privilege. I believe that the only way Americans can compete on the world market is to offer what other Westernized countries offer; free and accessible health care. Even if you disagree with me, however, there is no doubt that we need changes and we need them fast. Senator Tom Harkin pointed out that we spend twice as much as the European's countries spend health care but have poorer results because of the lack of preventative health care.

In his time on the floor Senator Harkin pointed out that the bill has provisions for seniors to have annual wellness visits and that it includes provisions for education on nutrition and smoking cessation. Those prevention measures save tons of money. A recent study on smoking cessation in Massachusetts found that in just two and a half years there was 26% drop in tobacco usage. The drop in tobacco usage showed up in 38% less hospitalizations for heart attacks, and 18% fewer ER visits and 12% fewer claims for adverse conditions from pregnancy. -- That’s an amazing result from just one type of prevention initiative.

For the prevention programs, the money that can be saved and the quality of human lives the bill has promise. It is not perfect legislation and it should have some kind of public option. There are earmarks and giveaways but legislators of all stripes wait till their vote is needed and then take care of the folks back home. That tactic has been going on for eons. This time is no exception. The old adage still applies -- don’t watch how laws and sausage are made -- and this bill is no exception to the rule. As Senator Harkin said this bill is a "starter home" and not a mansion. If you don’t have a home then it is great to get a roof over your head. This is a flawed first attempt but it is a roof to provide at least minimum shelter and outside of Medicare passed in 1965 and the legislation that created HMO’s there has been nothing really new in health care delivery. The time is now and the Democrats are seizing it.

Ellen Ratner is Washington bureau chief for Talk Radio News Service and a Fox News contributor.