Democrats got all red in the face with indignation a few years ago when Bill Frist threatened to use the nuclear option to push through W's judicial nominees. (After the nuclear option is used, only 51 votes would be needed to end a filibuster instead of 60.)  It's a politically thorny subject, but I think it's time to be blatantly hypocritical and put the nuclear option on the table.  Democrats must go all-in on health care.  It would arguably be the most important legislation of the century, and it would justify a change in Senate rules much more than mere lower-court judicial nominations.  Also, what's the point of protecting the 60-vote cloture requirement?  It paralyzes our legislative branch and is the principal reason the Senate is the World's Worst Deliberative Body.  I would be glad to see it go, even down the road when Republicans control Congress. 

But if it's going to be done, it needs to be a suprise tactic.  If Republicans get wind of the plan, they'd immediately flood the airwaves and force Democrats to defend it.  That would be bad.  Instead, the Dem leadership should meet secretly with Democratic senators and Joe Biden to prepare them to vote for the option when the motion arises.  Then, when the bill is on the floor, Democrats can swiftly and brutally move to an immediate vote.  Game, set, and match. 

It's a long shot, and there are other ways to pass health care reform, but I do hope Democrats keep this one in the back pocket.