by Patrick Appel

A reader writes:

Conor's post is breathtakingly obtuse on a couple of points.

(1) Its ignores the fact that passing reform through in piece-wise manner is nearly impossible to do given the polarization of Congress. Since 1994, I cannot recall of a single moment until this year when any element of insurance reform could have passed. The Republicans controlled Congress from 1995-2007 and Bush was president until 2009. When exactly was incremental reform going to be voted on? There are narrow windows (one-party rule) open to pass important legislation and this is one of them.
(2) A lot of the moving parts in the legislation are interrelated. Having a mandate is essential to preventing discrimination on the basis of preexisting conditions. Does anyone want to guess what happens if you try to pass both those pieces of reform separately? The public is overwhelmingly against the mandate, but for preventing discrimination on the basis of preexisting conditions. And what do we think will happen in this scenario? Either healthcare costs will fly through the rough or insurers will get a lot better at dodging the regulations against discrimination.

The only way to make an interconnected system work is to pass healthcare reform in a comprehensive manner. Congress isn't going to be allowed to cherry-pick that things they (and the pubic) like and dump the things they (and the public) dislike. Everyone loves government services, but hates paying for them. Piece-wise "reform" just gives you another giant boondoggle. The only way to make this work is to make people to swallow the bitter pill (cost controls, mandates) and argue that, on balance, the bill does more good than harm.

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