Reply #22: I can't speak for him but I'll say this.....

[Armstead]

The Democrats had a different choice than "all or nothing."

They could have set an agenda that tackled reforms in smaller bites, instead of a systemic change.

Start with the things that there had popular and widespread support (along a wide political spectrum) such as the pre-existing conditions, creating an exchange for people not covered by employers, providing subsidies to open up insurance to more people, etc. They could have also put in basic rate regulation that would have set basic levels and forced insurers to justify and receive approval for any increases beyond that. Etc.

That would have addressed many of the issues supporters of reform want. Then as step 2 they could have been a push for the more controversial and systemic aspects of reform, including what form a public option might take.

That way, something would have gotten done that would have fixed many of the specific problems right away, without putting in distorted and bad systemic polices that end up being the proverbial elephant (a horse drawn up by committee).