It's basically the same thing - they're trying to subvert the normal processes of the senate and avoid the filibuster with a questionably legal parliamentary maneuver. This isn't a budget bill. This is a normal piece of legislation. Reconciliation shouldn't be in play; it shouldn't even be an option. But they're going to change the rules and push it through in such a manner - the same sort of strong-handed tactics that they were accusing the republicans of just a few years ago.
Oh, but it was a constitutional crisis back then, it was going to ruin everything! Naked power grab!
They are not changing the rules. If reconciliation is used in this case it would be to alter a pre-existing law. You seem to have a misunderstanding about what is happening right now.
This is all about the Senate Healthcare bill that passed while the Democrats still had 60 votes and were able to wrangle enough votes to get it passed. The problem was that the House had passed a much more liberal bill and could not make it more consevative without losing votes.
Then Dems lost the 60 vote margin in the Senate. Odds of any sort of healthcare bill passing the Senate seem slim as long as Republicans are willing to let Americans die to advance thier political aims, but the Senate has still passed a bill, even though it had not been passed by the House.
So the plan becomes, get the House to pass the Senate bill as is so it doesn't get changed in committee, doesn't have to go through another Senate vote, and can go right to the President's desk for signing.
The House however hates the current bill as it is too conservative. They don't like all the compromises the Senate made in a misguided attempt to bring Republicans on board, so there is little chance of it making it through the House as is.
Now we get to the reconciliation process. Basically, it allows for certain modifications to the law to be passed within a certain time period by majority vote. The problem is that there is currently no law to modify. So the new plan becomes:
1) Have the Senate pass a reconciliation bill that makes what modifications they can to the Senate healthcare bill and send it to Obama, who does not sign it.
2) Have the House pass the Senate bill and send it to Obama.
3) Obama signs the Senate bill into law, then...
4) immediately after signing the Senate bill into law, he then signs the reconciliation act into law. Heck, they will probably both be on his desk at the same time when he signs them.
Now admittedly, this is all a bit lawyerball, but it is possible without any rule changes.
The Republican Nuclear option was basically bribing the umpire and convicing him to change the rules of baseball to suit your aims at any given moment. It would have allowed the majority party to run amok whenever they were in power, and even many in the GOP were reluctant to use it.