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The Reality Of All Or Nothing

James C. Capretta, a former Bush administration budget official, has a post at National Review entitled "The Myth of 'All Or Nothing.'" The purpose of the post is to entice Congressional Democrats to vote against health care reform by enticing with the possibility of a smaller, less controversial reform bill they could pass. Capretta talks up what Democrats call "the skinny bill," reported on by the Wall Street Journal, which would extend coverage to children and young adults up to age 26. It would be a nice little bill, but basically do nothing to address the pathologies of the insurance market, streamline the cost of medical care, or bring any relief to those suffering most from lack of insurance. Basically, it's the difference between winning the Super Bowl and winning an exhibition game.

The funny part of Capretta's post is when, after talking up the skinny bill, he feels compelled to note that even this meager step would meet with near total GOP opposition:

Of course, just because a plan is incremental does not mean it would entice bipartisan support. This particular version of an incremental plan probably wouldn’t get much Republican interest, given the heavy emphasis on expanding public insurance. It’s an incremental package, yes, but in a decidedly Democratic direction.

So maybe if they abandon comprehensive reform, Democrats can get something even more meager than the extremely meager skinny bill. Maybe discount aspirin for the uninsured!

So, in summary, yes, it's all or nothing.