- - Distribute / setuptools merge, e.g. cratering folks who use a
  distro-managed 'python-distribute' package.

This is the biggest issue. I wasn't involved and it could have been handled better sure.

what issue are we talking about exactly?

I'm aware of the "Import setuptools" problem during upgrades from distribute to setuptools:  https://github.com/pypa/pip/issues/1064
pip-1.4 does prevent that now (released last week)

but you specifically mentioned the linux distro name, "python-distribute"? 
I'm guessing maybe you're concerned with the scenario of how upgrading some project (that depends on setuptools/distribute) forces an unintended upgrade of distribute on a system where distribute is system-managed.
Is there a link to a tracker issue for that somewhere? 

3 solutions to ponder:
1) unreleasing the distribute-0.7.3 wrapper, and making any upgrades from distribute to setuptools manual. 
2) changing pip's -U logic to not recursively upgrade satisfied dependencies, but that's a *big* change (it's a long story, but there are tentative plans in 1.5 for changing it)
3) in a patch release, include a special case for distribute to *not* upgrade if satisfied (when distribute is a dependency in the requirement set).

Marcus