The absence of a civilized healthcare system in the United States, almost alone among wealthy nations, results in tens of thousands of unnecessary deaths every year. But if something is to be done soon to save lives it is not going to be done in Washington, D.C. It is going to be done in Sacramento, Harrisburg, Columbus, Springfield, Augusta, Denver. And then it's going to be blocked by lawsuits from health insurance corporations and preemptive language in federal legislation.

The very best possible bills now under consideration in Congress are largely bailouts for health insurance companies at public expense. The "public option," which was originally sold to us as a path toward a single-payer solution or Medicare for all, has been reduced to -- at best -- a token mitigating factor in a catastrophically bad law. And states may be permitted to opt out of it. So most people across the country won't be allowed to use the public option, and in some states nobody at all will.

Hurray for states' rights! But this has nothing to do with states' rights. We're permitting states to make our healthcare policies worse, but not necessarily better. The driving force seems to be concern for health insurance companies' rights.

The mammoth healthcare bills being carted around the U.S. Capitol on hand-trucks are likely to deprive states of the power to take useful steps to provide their citizens with healthcare, and unlikely to allow states to waive existing federal laws preventing life-saving action.

Back in July, the House Committee on Education and Labor did something right, something that could make all the difference in the world to millions of Americans, unless we allow the congressional "leadership" to unceremoniously undo it. Congressman Dennis Kucinich introduced in the committee an amendment that would effectively allow states to improve on our healthcare system if they choose to, allow them to create state-level single-payer healthcare. There are bills to do this in several state legislatures already. Such a bill has passed and been vetoed in California twice, where a change in governor is imminent.

President Obama told the committee chairman, George Miller, to oppose Kucinich's amendment, and he did so, leading off the voting with a resounding "No." But the Democrats voted 14 to 14 with one member passing and two failing to vote. And the Republicans voted 13 to 5 with one member failing to vote. That added up to 27 yes votes and 19 no votes. Some Republicans may have voted yes simply because the chairman voted no, but they said they were voting yes for states' rights. And that would be a sensible, decent, and constitutional position. Why shouldn't states be permitted to do better, as well as worse, than Washington, even if the insurance companies bring in less blood money?

Canada got its healthcare system in one province first. If California or Pennsylvania joins the civilized world and treats healthcare as a right, and eliminates the waste and bureaucracy of the health insurance companies, our whole nation may just be forced to come along, or watch half the population migrate to California and Pennsylvania.

Of course we could create a Medicare for All system at the national level immediately. It would take a far shorter piece of legislation than what's under consideration, and one that everyone could understand. It would save money. It would save lives. It would not force anyone to give their hard-earned pay to wasteful health insurance companies. And the House has scheduled a vote on doing just that, on what has come to be called the Weiner Amendment, sponsored by Congressman Anthony Weiner. We certainly need as many yes votes on this as possible. We also need as many no votes as possible on any bill that does more harm than good. Then we can come back in round two with a more honest debate, one that includes the single-payer solution.

However, the approach that congress members are currently taking should give you pause about failing to speak up for the Kucinich amendment before it's too late. A conversation I had with Congresswoman Betty Sutton is typical. She told me that the Kucinich Amendment was no big deal and shouldn't be paid any attention to. She said she wanted everyone to focus on the Weiner Amendment on which she planned to vote yes. Asked if there was any chance the Weiner Amendment would pass, she replied of course not.

From Congresswoman Sutton's point of view, a bill that will fail is far more important than a life-saving measure in a bill that might pass, because she plans to vote right on the former and brag about it to her constituents. "See, I tried. I really tried." But if Sutton's state, Ohio, passes the bill currently making its way through the state legislature and establishes single-payer for all Ohioans, the death panels, aka health insurance companies, will sue. And without the Kucinich Amendment they will win or at least hold things up for several years and several thousand deaths.

If we made enough noise now, we could force Congress not to strip out the Kucinich Amendment. A first step would be a phone call to Nancy Pelosi and your Congress member.

That being done, we could still support or oppose the overall bill based on an analysis of all the details, but we would at the very least have laid the groundwork for inclusion of the Kucinich amendment in round two or for its passage as stand-alone legislation. This would conflict with our ongoing struggle for national Medicare for All only in the twisted confines of our own daydreams.

Open up the real possibility for California to act on behalf of its residents and you create an enormous new lever for prying the insurance executives' claws out of our representatives in Congress. Think about it. Do something about it.

David Swanson is the author of the new book "Daybreak: Undoing the Imperial Presidency and Forming a More Perfect Union" by Seven Stories Press. You can order it and find out when tour will be in your town: http://davidswanson.org/book .