Dick Durbin discusses the challenge of getting 60 votes on Morning Joe. Progressives, such as Howard Dean, say democrats only need 51 votes using the so-called "reconciliation" process. Here's a good explanation of why that won't necessarily work. It seems to me that if you can't muster 60 votes for a bill, then it probably isn't a very good bill and it probably shouldn't pass.
Durbin also tells why allowing people to buy insurance across state lines wouldn't work, unless a national standard was put into place.