"Tonight we have more momentum than we've ever had in the history of health care discussions,'" Biden told about 1,000 Democrats in Des Moines.

Biden's comments at the Iowa Democratic Party's largest fundraiser, the Jefferson Jackson Dinner, came shortly after the 60-39 vote in the Senate that cleared the way for a full-scale debate on the health care bill. Biden said his speech was delayed as he worked the phone to lobby swing lawmakers.

"I see the special interests raising tens of millions of dollars, hundreds of millions of dollars to defeat our agenda," Biden said. "We've never thought change would be easy. You all knew change would be hard. It's hard to change the direction of a nation that's been adrift for at least eight years."

He pointed to the Senate's vote as the latest sign of progress.

"Those who voted for reform with be rewarded and those who voted against it will be held accountable," Biden said.

Republicans have cast the health care bill as a costly government takeover, built on budget gimmicks.

The 39 senators who voted against moving forward with debate were all Republicans, and the House approved its version of the bill earlier this month on a near party line vote.

Biden argued that as issues such as health care begin to take shape, Democrats will reap political gain. He dismissed many of the administration's noisy critics.

"Progress in this country has never been produced by yelling and saying no," Biden said. "For those of you who stood with Barack Obama from the beginning, you have heard the doubters. When Barack and I talked about change we meant it."