As the House of Representatives inches toward a final vote on comprehensive health care reform this weekend -- the most dramatic domestic policy debate in several generations, a reorganization of a sixth of the economy - the only thing the parties can talk about is abortion and immigration.

"It tells you something about our country," remarked one distressed member of Congress, who didn't want to be named speaking ill of this fine land.

What it tells isn't pretty: The ranks of the uninsured are steadily being filled, with the number approaching 50 million. Health care costs are rising at a rate several times that of inflation, eating into the take-home income of the majority of the American people and threatening to break the federal budget in less than a decade.

Yet the talk is of abortion and immigration.

All day on Friday, House leaders struggled to reconcile the pro-life and pro-choice wings of the Democratic Party. Over the last several weeks, the pro-choice bloc, consisting of nearly 200 Democrats, had gradually come to terms with an amendment authored by Rep. Lois Capps (D-Calif.).

The intent of the amendment was to keep the debate about health care rather than abortion and it would make clear that - as is current law - no federal funds would be used for abortion. "Our hope was that we could continue the current ban on federal funding for abortion so the issue wouldn't bog down the overall health reform legislation," wrote Capps at the time.

That wasn't enough for pro-life Democrats. On November 3, Rep. Brad Ellsworth (D-Ind.) offered a more conservative compromise, one that restricted abortion in a bunch of extra ways and would require one private plan in the exchange not to cover abortion.

The divorce from reality had been filed by this point, considering that most insurance plans -- even using pro-life numbers -- do not cover abortion.

Still, pro-choice Democrats swallowed the compromise, but said they'd go no further. Health care reform, said Rep. Lynn Woolsey (D-Calif.), a staunch pro-choicer and co-chair of the Congressional Progressive Caucus, should not be a vehicle to drive a pro-life social agenda.

That's when Rep. Bart Stupak (D-Mich.) re-entered the debate. Stupak is a longtime pro-life advocate and had been pressing his concerns upon House leadership. On Friday, Ellsworth withdrew his compromise language from negotiations, according to several House sources, sending the debate back to the starting line, where Stupak was waiting.

Stupak, in meetings with Pelosi and other members of leadership, pressed to include, instead, his own amendment that would ban the public health insurance option from funding abortion and also ban any private plan operating within the exchange from funding abortions. Under Stupak's plan, a woman buying private insurance from within the exchange with her own money would not have a choice of a plan that covered abortion.

During the early afternoon, Pelosi was leaning toward including some more moderately blended version of Stupak and Ellsworth's amendment's as part of the health care bill that would be sent to the floor, several aides told HuffPost. Just before 5:00 PM, Stupak and Rep. Henry Waxman (D-Calif.), who battled over abortion while the bill moved through Waxman's Energy and Commerce Committee, huddled on the House floor. Leaving the floor, the generally talkative Waxman gruffly brushed off reporters, asserting his alleged right "not to be swarmed."

Tempers flared. A Democratic congressman told House Republicans, who then told the Huffington Post, that Rep. Diana DeGette (D-Colo.) was asked to leave a leadership meeting where the pro-life agreement was being considered. DeGette is firmly pro-choice, and it was thought, the source said, that she would not agree to the deal. "False," said a leadership aide, saying that "she had to leave to attend another meeting. Other pro-choice members [were] in there with leadership, as well as Waxman."

Either way, the question came down to who had the votes. Stupak's driving argument was that he had more than the forty members he needed to "take down the rule" - legislative lingo for defeating a bill on the House floor before it comes for a final vote. No one was sure whether Stupak actually had the 40 votes, but pro-choice Democrats were skeptical.

As the night and the meetings wore on, Pelosi shifted, multiple aides said, and was leaning toward allowing a floor vote on the Stupak-Ellsworth amendment rather than inserting it into the bill. The logical conclusion is that Pelosi determined she would lose too many pro-choice and progressive votes in the process of harnessing pro-life Democrats.

Shortly after midnight, Stupak addressed the Rules Committee and requested a floor vote on the amendment, ending a day of drama, but leaving open questions that will be answered tomorrow: Does his amendment have enough votes to pass? If it does, will pro-choice Democrats flee and sink the bill?

The thinking among leadership is that allowing a vote -- regardless of the outcome -- helps win votes for final passage. If it passes, then pro-lifers line up behind health care reform. If it fails, at least they had their vote. For pro-choicers, if the amendment passes they can still fight to remove it during negotiations with the Senate -- which rejected tough abortion restrictions.

Meanwhile, aides from both parties say, the GOP is planning out how it will game the language in its motion to recommit - an alternative measure aimed at stamping out the bill that the minority is entitled to introduce. The GOP could include language supporting Democrat-backed proposals, such as single-payer health care or a robust public option -- and then vote present, allowing a majority of Democrats to carry the vote to victory and complicate things for leadership. (Dems probably wouldn't have the votes, however, for single-payer, believe it or not.)

Or the GOP could toss out anti-immigration language. That effort could garner the support of a big enough bloc of Democrats to give Pelosi genuine concern that it could prevail. Here we wander further from reality: undocumented workers currently get free medical care at great expense to the American people at emergency rooms across the country. The GOP's alternative approach, as it's been described in the past, denies that reality while simultaneously turning businesses into immigration-enforcement arms. People here illegally, however, would still be able to go to the emergency room for free.

Lost in the back and forth are the tens of millions without insurance and the nation's broken health care system. More surprising than the behavior of Congress, perhaps, is the fact that it has gotten as far as it has.