I am one of those pessimists. Sure, they will enact something and it will be better than what we have. Democrats have to do that or they are in deep, deep trouble down the road I think. And, they have the votes to do it if they can get the blue dogs democrats to come along.... without their support, Dems don't have the votes and so far they do not have their support.

So, what's the real test as to whether or not the reform was as good as it should have been or is just lip service to say Congress did something? Keeping in mind that the insurance industry actually supports everybody getting coverage (that's a lot of new customers, right), what should we be looking for?

1. Anybody who wants health insurance can purchase it at a reasonable price without regard to pre-existing conditions. Big step, but no where near universal and for sure that won't cover the poor or the homeless and probably not some of those between jobs.... no job, no income and no savings = no such thing as a reasonable rate.

2. Mandated fixed premiums (based on age, sex or something but standardized within a group). Another big step. Could happen.

3. A standardized set of services/coverage that all insurance policies must provide. We should stop the practice of capping services at a set dollar amount or set number of visits, days, etc. Do away with crap like you can have a wheelchair covered up to $500... when a good one for someone with severe disabilities will run closer to $5,000. Do away with medically necessary, but not covered services. Good luck on this one, too.

4. Standardized caps on out of pocket expense from co-pays, deductibles and such. This is key if we really are going to stop people from going bankrupt over health care. Again, good luck.

5. Is a public option based on income/assets made available? This is my key... if we don't get this, we got lip service and did not address the problem in any big way because everything is still tied to your economic situation and your employer still has you in a very tight choke hold.

Others?

The US Senate is a strange place with arcane rules, loop holes, and exceptions to loop holes. I suspect (but don't know for sure) that the 60 vote thing is referring to the number of votes necessary to override a filibuster and force a vote on a piece of legislation. I'm no expert in such things, but I wouldn't be entirely surprised if the Republicans found a procedural way to block a vote or force an override of a filibuster. It's called invoking "cloture." Originally, forcing cloture required a 2/3 majority, but was later reduced to 60 votes.