One of the reasons people have thought that health-care reform is likely to pass is that the Senate Democratic leaders have insisted on party loyalty on procedural votes related to it. In other words, the leaders (and, one assumes, the netroots) will go easier on Democratic senators who vote against the legislation than on senators who vote to keep debate going. Doesn’t the doc-fix vote make it a tiny bit harder to maintain that party discipline? Thirteen Democratic senators just voted against Reid on a procedural vote on a health-care bill.