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Obamacare asks too much of Washington

Nov 14, 2013 - By The Chicago Tribune

The Affordable Care Act was supposed to be a great advance in fostering access to medical insurance. It would contain costs, guarantee coverage, simplify consumer shopping, and make the entire system more rational. Now that it is being put into practice, however, it's a giant, exasperating mess.

Just one example: In North Dakota, WDAY-TV reported that only 30 people have signed up for coverage on the new federally run exchange. But 35,000 people will lose their existing policies. That was not quite what was promised during the congressional debate.

Some of the fault lies with the Obama administration for promising more than it could deliver. But some of the fault lies with the American people, who sometimes demand more of their government than it can reasonably provide. The technical and management snafus with Obamacare may be fixed in time. The deeper problems in the effort won't be so easy to solve.

In 1964, 76 percent of Americans trusted the federal government to do the right thing most of the time. Today, the figure is just 19 percent. It may be no coincidence that the decline in confidence occurred at the same time Washington was steadily expanding its role in a wide variety of spheres, from health care to housing to education.

When the government tries to do more and more, it raises hopes that are hard to meet. It gets further from its essential responsibilities, like defending the nation from foreign threats, fostering a sound national economy, and facilitating interstate transportation.

It also spends more and more. In 1964, federal outlays accounted for 18.5 percent of gross domestic product. Today, they take 22.7 percent. But it doesn't tax accordingly. This year, government revenues are lower as a share of GDP than they were back then, before the creation of the Great Society.

Why the discrepancy? Americans like getting things from Washington more than they like paying for them. Our leaders accommodate that taste by running big deficits every year, leaving much of the cost to be borne by future taxpayers.

But often, what the citizenry gets from Washington falls well short of expectations. Obamacare is a good example. Its introduction may have been bungled in several ways, but making big changes in a sector that constitutes one-sixth of the entire economy is a mammoth task, with great potential for error and harm.

The first step toward better federal policy is for Americans to realize the limits of what it can do and the costs it imposes when it goes beyond those limits. There's not much sense in regarding the government as untrustworthy and inept, and then giving it more opportunities to screw up.

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Affordable Care Act