After almost a year of congressional legislative lassitude, both houses of Congress passed a tax bill, the Senate most recently last week.  While the two versions are similar, there are minor differences that must be reconciled before sending a bill to the White House for President Trump's signature.

The Heritage Foundation compared the two versions, as shown in the chart below.  The differences are minor, window dressing, with two major exceptions.

The Senate version repeals the Obamacare individual mandate, while the House version keeps it in place.  It should go.  Senate version wins.

Then again, the House version repeals both the individual and corporate alternative minimum taxes, whereas the Senate version keeps both.  Both should go.  House version wins.

Now what?  The two versions go to a conference committee, where these differences are reconciled – hopefully ironed out, taking the best provisions of each bill, combining them into something even better.  The finished product then has to pass both chambers of Congress again before traveling across town for President Trump's signature.

What could go wrong?  Plenty.  It took much wheeling and dealing to pass the Senate bill.  Certainly, any tax bill will have zero Democrat support.  After eight years of Obama nearly doubling the national debt, although with some Republican help, Democrats are suddenly concerned about deficits.  And they will not support any Republican legislation just out of partisanship.

There is also the cadre of #NeverTrump Republicans – Flake, Corker, McCain, Murkowski, Collins – jockeying to see who will cast the crucial nay vote to torpedo the bill and throw a wrench into the Trump agenda.  This is why Roy Moore's likely arrival and Al Franken's likely departure from the Senate are quite important.

What are Republicans to do?

The smart thing is also the hardest thing.  As the expression goes, "no pain, no gain."  Leadership requires heavy lifting, which Mitch McConnell and Paul Ryan may not be up to or have the desire for.  Trump can do only so much, as he is not the leader of the House or Senate.  Those jobs fall to Mitch and Paul.

This is a historic once-in-a-generation chance to reform the tax code. Republicans control both houses of Congress and the White House.  It won't get better than this.  It's an opportunity that should not be squandered – as happened with Republicans' failure to repeal Obamacare despite years of campaign promises to the contrary.

Take the best of both bills, jettison the worst, and craft something even better.  Ignore the braying of the left and their "tax cuts for the rich" canard.  Neither bill cuts taxes for "the rich," those paying most of the income tax already.  Both bills will spur the economy.  Republicans should use another talking point for the left from over 50 years ago that leftists conveniently overlook: "a rising tide lifts all boats."

The alternative for the GOP is to quit while ahead, the House simply passing the Senate bill and sending it to the president – not ideal but, given this current Congress's lack of accomplishment, a reasonable compromise.  It would be a "perfect is the enemy of the good" approach, similar to how the House passed the Senate version of Obamacare in 2010, not risking conference and a new bill, which might not withstand a Republican filibuster in the Senate.

The Democrats didn't get all they wanted but did get a bill they could live with.  Of course, future Republican congresses could repeal Obamacare, but not surprisingly, when the future is now, Republicans fell short.

That's the current conundrum for congressional Republicans.  Make the bill better in conference and hope to pass it again through both Houses of Congress?  Or let the House pass the Senate bill and call it a day?

Personally, I prefer a better bill, but given the track record of Congress over the past year, I would happily accept the Senate bill signed into law by the president before Christmas.

Suppose they take the tax bill to conference, and it fails to pass both houses once in final form, with McCain, Flake, or Corker casting the decisive nay vote.  Another GOP failure – enough to make much of the GOP base stay home next November, potentially losing the House in the midterms.  Any guesses as to what would happen to President Trump on the impeachment front if Democrats captured the House?  Or Senate?  Lots at stake.

Remember the old Let's Make a Deal show?  You could keep the prize you have or trade it for whatever is behind curtain number two – which, in this case, might be a handful of GOP senators, on their way out of office, happy to stick the president with a booby prize.

Do Mitch and Paul want to roll the dice?  Risking losing the entire bill and with it possible loss of control of Congress after the 2018 midterm elections?  Or take the easy win and move on to confirming judges, repealing Obamacare, and building the wall?  A real conundrum.

Brian C Joondeph, M.D., MPS, is a Denver-based physician and writer.  Follow him on Facebook, LinkedIn, and Twitter.