Amid the wreckage of the health care debate, some rescue workers have been searching for small pieces that could be salvaged. On Tuesday, House Speaker Nancy Pelosi (D-Calif.) suggested that the search was in vain. What good is a door, after all, without a building?
The health care system is so complex, Pelosi argued, that it can't be changed piece by piece. She used the example of the popular ban on discriminating against people with preexisting conditions: Simply passing a law saying that all insurers must take such people would lead either to prohibitively expensive insurance for them, an increase in premiums overall, or both.
Passing such a bill might be politically popular, but it wouldn't help real people, she said.
"There are some things that sound easy, but you might as well send somebody a get well card, because they don't have any more impact, except maybe they make you feel good for the moment," said Pelosi, who paused and rethought her comparison.
"Maybe a get well card might be more effective, as a matter of fact, because it's sincere," she said.
"Some people have suggested that we should do [insurance reforms] freestanding, but it's important to note the following: You can't do that freestanding unless you have the basic underpinnings of a bill, because otherwise you're making a statement, but you're not making a difference in anyone's life, because it's not tied to the accountability of the insurance companies," she said. "You could get all of those things--insurance companies will price it out of everybody's range. So they would be factors for increased costs and premiums, rather than reforms of the insurance industry, unless they go along with a bill that is underlying, that we hope that we will be able to pass before too long."