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Sixty-four years ago, President Harry Truman stood before a joint session of Congress and called on the body “to assure the right to adequate medical care and protection from the economic fears of sickness.”

Forty-nine years later, President Bill Clinton made the same demand.

On Tuesday afternoon, the U.S. Congress moved closer to achieving that goal than it ever has. The hold-out Senate Finance Committee voted by a 14-9 margin to move the fifth and final health care reform proposal through the conservative panel.

The package, coming in at under $900 billion over ten years, is the least generous in terms of subsidies for working and middle-class Americans to purchase health insurance, and it does not include a national public health insurance option. But the bill would dramatically reorganize the nation’s system of health care and health insurance and stands as the foundation on which Democrats hope to build a strong reform package with negligible GOP support.