If the cost of perfect reform is a century of suffering where the benefits don’t kick in until that happens, the discounting completely kills the benefits (especially if you use preference based discounting). That makes it even less sensical. Doing things soon is worth an incredible amount more than waiting.
Anyone advocating waiting–or policy changes that amount to the same thing–probably doesn’t accept that expanding insurance coverage is a worthwhile goal.
It’s not as if the ideas of the ACA were just thrown together to get the uninsured covered ASAP. This nation has been struggling with the issue of the uninsured for decades. A lot of ideas have been offered and put to a legislative test. (Notice I did not say “vote.”) None others passed. The one that did has also been tested in Massachusetts. With respect to covering the uninsured, it’s working pretty well. Kinda means something.