Incrementalism vs. comprehensive change

INCREMENTALISM VS. COMPREHENSIVE CHANGE…. On health care, a key GOP talking point, outside concerns over process, is more of a meta observation: “comprehensive” approaches to public policy are fundamentally misguided.

Lamar Alexander has been a leading voice on the Republican side for incrementalism. His argument is that the White House erred by trying to pass such a big, sweeping reform bill, and so Democrats and Republicans should instead get together and pass popular parts of reform, one piece at a time. Analysts have pointed out that many reform ideas don’t really work on their own; they have to be passed altogether in order to make the system work.

Right. There are plenty of parts to reform, but they’re inter-locking. It’s easy to say we’ll take some steps now, and leave others for later, but to make it so that those with pre-existing conditions aren’t discriminated against, for example, we’ll need mandates and subsidies. It’s like an engine — the parts don’t work unless they’re part of a larger whole.

What’s interesting, though, is that Republicans used to understand this — not in some previous generation, but very recently. Senate Minority Leader Mitch McConnell (R-Ky.) said over the summer that “comprehensive” reform is “long overdue.”

Around the same time, Republican Sens. Grassley, Kyl, and Enzi agreed that they support moving on a “comprehensive, inclusive” package.

Republicans have discovered that “comprehensive” is suddenly something to avoid, but they only came to that conclusion after the House and Senate already passed reform.