Well, with micropatching you don't need to reboot and you only have to review minimum code changes - and if the patch is not working for you you can unpatch it (with proper permissions, ofcourse).
What about getting vendors into changing their patching habbits? Instead of packing some hundred mega patches just provide micro ones when needed? As you said 0day issues are usually (not allways) easy to fix. Probably you alone are skilled enough to check this couple of code instructions by yourself - which is not the case with full-blown patch Tuesday packages. I am pretty sure that process could be much cheaper for MS.