When history called the U.S. House Saturday to give millions more Americans affordable health care -- something which other advanced nations routinely provide their citizens -- some members seized the moment and some remained blind or indifferent.

The 220-215 vote was perilously close, but many great battles are decided that way. To their lasting shame, every Republican but one lined up against the bill. Sadly, the GOP remains captive to ideology, insisting against the evidence that this is socialistic, government-run health care when private insurance companies remain very much part of the picture and the public option may not survive in the Senate.

At least the Republicans are consistent, having done nothing to solve the health-care crisis during eight-year Bush administration, even as it grew steadily worse. They stand athwart history yelling "no" and history is coming upon them like a locomotive.

But what can be said for the 39 Democrats who voted "no" on Barack Obama's signature campaign issue? One of them was Rep. Jason Altmire of McCandless, who was elected in 2006 promising that his years in the health-care industry would make him a fighter for reform. Instead, he was the industry's loyal representative on the House floor.

For all his coy pretense that he hadn't made up his mind, he voted "no" when the moment came, preferring self-preservation in a conservative-leaning district to keeping faith with those who first elected him.

By his own admission, the bill he opposed contained "some improvements" on three issues he says he cares about -- rising health-care costs, burdens on small businesses and raising taxes. But the provisions were not enough for him to support the measure and in retrospect it seems clear that they would never be sufficient. His vote was the same that would have been cast by Republican Melissa Hart, his predecessor, if she were still representing the 4th District.

Some commentators had the House bill dead before it was passed and now say the same of its fate in the Senate, where a rival bill stands ready. To be sure, the same problems and more stand in the way of success -- especially in the form of erstwhile Democrat Sen. Joseph Lieberman. But history is waiting to be made and the chances are much greater after Saturday's vote.

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