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The Atlantic’s Marc Ambinder examines the health insurance reform bill now that Senate Democrats have pulled off the 60 votes needed for cloture. He is both pragmatic and informed.

Assuming the bill does not have a catastrophic impact on the system, it will probably be popular in the long-run, even though it is not a strict entitlement — people are going to have to pay for it. Republicans are probably correct in assuming that Democrats are going to add, incrementally, to the foundation they’ve laid. There will be a balance of incentives on individuals to make health care decisions more carefully and more pressure on providers and insurers to make them more judiciously. I’d expect the balance to shift more toward the providers and insurers and away from patients. We’re not going to end up with a single-payer system, but we are going to end up with a system that, more and more, is predicated on insurers and providers being held accountable for their standard of care.