Whether President Obama gets a final up-or-down vote on health care in the next two weeks, as he wants, or a little later, it hardly matters now. What seems certain is that, with the president's prodding and engaged commitment at last, a final vote on comprehensive reform again seems probable.

If Democrats can stand together behind legislation for the common health-care interests of all Americans against Republicans' no-holds-barred opposition and unbelievable distortion of the merits of reform, Americans will get what we have long deserved. If Congress fails then to pass reform, it will be a moral, and deeply wounding, failure.

What has become most ironic about the struggle for health care reform, indeed, is the vast and deceitful fabric of distortions and outright lies spouted by enemies of reform in their attempt to defeat the effort to fix the nation's most elemental problem.

Republicans, for example, have gone from warning about so-called death panels to berating Democrats for attempting to ram reform and an unbridled government takeover of health care down the throats of Americans who, they say, don't want it.

In fact, there were never any death panels. Reform does not constitute a "government takeover" of health care. And the majority of Americans say they want most or all of the major elements of reform -- fair rules on insurance companies' rates and coverage, lower-cost insurance exchanges and ways to achieve efficiencies in the medical industry -- when the questions are posed without the Republicans' scare-tactic slant of "do you want a government takeover of health care."

Indeed, reform is not a threat to Americans. It is the necessary solution to the out-of-control costs of the present system that threatens the solvency not just of Medicare, Medicaid and Tri-care for veterans, but of the health care system itself.

Reform will pay for itself by holding down costs and new efficiency measures. It is the un-reformed status quo that will double health care spending over the next 10 years, vastly outpace wage gains, threaten the competitiveness of companies, and force more small employers drop their coverage altogether.

Those trends have been worsening at an alarming rate for years. A new study by the Urban Institute, for example, shows that just 35.6 percent of small firms with fewer than 10 employees still offered health insurance in 2008, down from nearly 40 percent in 2000. Just 66.1 percent of firms with 11-to-24 employees still offered subsidized company policies in 2008.

Overall, just 57.3 percent of the estimated 47.8 million Americans employed in firms of less of than 100 employees had employer-based coverage in 2008. Without reform, the percentage of coverage in this group could drop to 45 percent by 2019.

These dismal statistics help explain why more than 90 million Americans now do not have access to health insurance coverage through either their own employer, or that of a family member.

In addition, roughly 13,000 Americans lose their health insurance every day due to job losses, unaffordable premium increases, or an employer's difficult decision to quit providing company-subsidized coverage due to continually soaring costs. Some 5,000 Americans lose their homes every day due to medical bankruptcy.

And the plight of under-insured workers -- Americans whose insurance coverage carries very high deductibles, co-pays, and restrictive coverage riders -- continues to worsen.

More talk about health care reform won't do. The country needs reform now, and Americans deserve, finally, access to secure, affordable health care. If Republicans had rather focus on scare tactics, politics and helping the insurance industry maintain its big profits instead of helping Americans to a better health system, that should be their party's problem, not the nation's.