As the botched rollout of the Healthcare.gov website reminded us, big government projects can be messy. Fairly or unfairly, recent events will serve as fodder for politicians who like to claim that government is not the solution to our problems and is more often the problem.
And yet the government tends to get involved where real needs exist, usually due to market shortfalls. Lack of health insurance, unaffordable flood insurance, difficulties obtaining housing, lack of access to higher education, etc., are real problems, and American voters have repeatedly expressed their frustration over them and their support for candidates who offer solutions.
Except ... these needs run against a peculiar American ideological strain that rejects most (or even all) signs of federal power and equates even modest levels of taxation with tyranny or socialism. Thus has the American political system developed an unusual way of meeting citizens' needs while attempting to hide the fact that it is doing so. This system has been dubbed "the submerged state" by political scientist Suzanne Mettler and, relatedly, "the kludgeocracy" by political scientist Steven Teles.
Even Senator Ted Cruz gets help from the taxpayers, despite his claims to the contrary; his wife's private health insurance plan is provided through a tax exemption.
As Mettler shows in her work, such a form of public policy tends to lead to perverse understandings of American politics by its citizens. For example, many people wish to buy homes, and the federal government wants to see more people owning homes, as homeownership produces desirable qualities in citizens and the housing sector is an enormous part of the economy. But houses are expensive. So rather than produce some federal bureaucracy that helps people afford homes or sets price caps on them, Congress instead inserted the home mortgage interest deduction into the tax code. The federal government spends about $100 billion per year on this program, but most of its beneficiaries either don't know about it or don't think that they are benefiting from a federal program. Indeed, some 96 percent of Americans rely on some federal largesse at some point in their lives, coming in the form of subsidies or tax deductions, but most of us think of ourselves as independent. Even Senator Ted Cruz, as John Sides points out, gets help from the taxpayers, despite his claims to the contrary; his wife's private health insurance plan is provided through a tax exemption.
All of this means that policymakers who actually want to use government to make Americans' lives better face the difficult task of doing so while making it appear that they're not doing anything. This helps us to understand why the Affordable Care Act was such a monumental and complex undertaking (and why the bill was so long). The government was responding to real and growing concerns —sharp increases in the costs of health care and the growing number of citizens without insurance. It would have been eminently easier (and probably cheaper and more efficient) to simply make the federal government the sole provider of health insurance, essentially Medicare for all. And yet that was not remotely within the realm of the politically possible, even with Democrats holding large majorities in Congress.
Thus did Congress construct an intricate system of health exchanges that leaves citizens still being insured by private companies, but with guarantees of coverage and lower costs. (Of course, even this was described as a Commie/Nazi takeover.) And while there's no excuse for the poor functioning of the Healthcare.gov website, is it at all mysterious why such a website, culling information from hundreds of different insurance vendors across various states, would be such a daunting project?
This also helps us understand why Americans take such a dim view of Congress. In addition to all the fighting and posturing that necessarily occurs in a deliberative legislature, here's a body whose main job is to fix our problems while making it look like it's not trying to fix our problems. Good luck with that.