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Posted at 9:52 AM ET, 01/24/2011

Are we done talking about big government?

By Ezra Klein


Jon Chait and Matt Yglesias are kicking around the idea that the passage of the Affordable Care Act fills the final major hole in the American safety net and means, as Matt says, that "the era of big government liberalism" is over and "future public policy has to be about ways to maximize sustainable economic growth, and ways to maximize the efficiency with which services are delivered."

I'd rephrase that slightly: I think the era in which the government's major commitments are the dominant issue is (largely) over. The Affordable Care Act doesn't make the government much larger as a share of GDP. Rather, it commits the government to guaranteeing something close to universal health care, even if the relevant transactions occur between individuals and private insurance companies. The reason the GOP talks about "repeal and replace" is that they don't think they can persuade Americans to undo that underlying commitment. If they did, they'd just go for repeal.

But the fights over how government should look will be as fierce as the battles over what it should do -- and may, rather oddly, fall much more cleanly across big government/small government lines. Social Security, Medicare, Medicaid and the Affordable Care Act will all require substantial changes in the years to come. Most of those changes have less to do with the programs themselves than with underlying cost growth in the sectors of the economy they encompass -- health-care provision and pensions, both of which will harm private firms and paychecks as surely as they'll wound government budgets. But as both parties struggle to find answers for that cost growth, they'll likely end up adding longtime ideological commitments actual answers -- or substituting them for actual answers: Conservatives will look to fully or partially privatize Social Security, Medicare and Medicaid, while liberals will look to empower the government to add a federally sponsored insurer and bargain down costs in the Affordable Care Act.

This might actually mean more arguments over "big government liberalism" than we've seen in recent decades. Democrats were so focused on the question of the government's commitments that they ended up making a lot of compromises on how those commitments got carried out. The Medicare Prescription Drug Benefit, the Affordable Care Act and the tendency to disguise social programs disguised as tax credits all fit this pattern. But with the commitments established, I wouldn't be surprised to see Democrats become much less willing to make those compromises going forward. And if the GOP can't roll back the commitments, a lot of their energy will turn toward privatization.

This is the fundamental reality underneath Paul Ryan's Roadmap, for instance, which uses the need for long-term cost control as a justification for eventual privatization (even though the privatization schemes are not how his plan saves money). His Roadmap is the most radical salvo in the big government/small government debate that any politician has launched in some time, but it's framed as an exercise in cost control, and it makes a point to avoid questioning any of the government's underlying commitments.

Photo credit: Melina Mara/The Washington Post.

By Ezra Klein  | January 24, 2011; 9:52 AM ET
Categories:  Government  
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You assert that "Social Security, Medicare, Medicaid and the Affordable Care Act will all require substantial changes in the years to come."

What, other than the Washington Post's desire to harm Social Security by reducing benefits, causes you to put Social Security on that list?

Yes, that is where (dedicated) tax revenues will be spent as (dedicated) Treasuries are rolled over (to general, unrestricted Treasuries) and payments are funded.

But I am with Harry Reid. "The folks who want to change Social Security are folks who don't like government."

So why are YOU on the list of folks bringing it up as though it needs attention?

Posted by: grooft | January 24, 2011 10:08 AM | Report abuse

"Most of those changes have less to do with the programs themselves than with underlying cost growth in the sectors of the economy they encompass"

No, that's not true, as you point out in your last post. The Republicans are focused on making programs work *less* effectively because one party refuses to believe the non-partisan CBO. That's intentional, and it's also a sign of things to come. It's also scary because while the left has no big, unifying battles to fight for anymore, the right will still continue to privatize everything in sight, making government work far worse. It's rational policy making versus ideology. That's not a fair fight.

I think the only solution is filibuster reform and more parliamentarianism.

For example, the GOP isn't going ahead with HCR repeal because it's valuable to have a perpetually unwinnable issue -- its red meat for the Tea Partiers. But if you gave more agency and responsibility to whatever party's in power, you would proportionally reduce victimization, cynicism and extremism. When you're in charge, it's tougher to shift blame and tougher to follow something like Ryan's roadmap. And if something like the roadmap is actually followed, the public can more effectively assign blame. Freedom to make policy means better policy will be made.

The only viable future for the left is to make policy preferences more possible. Without that, the right will always have the luxury of not being accountable for things like bad CBO scores, because their base is more animated by feelings of powerlessness or victimization and less by policy. Suddenly making things possible will moderate their rhetoric and their policy proposals. Not doing anything will ensure a long, losing battle for lefty technocrats against fiery ideologues.

Posted by: Chris_ | January 24, 2011 10:29 AM | Report abuse

The big question, in other words, is whether the role of government is to deliver benefits to all citizens, or just to pay lip service to that idea.

Posted by: paul314 | January 24, 2011 11:17 AM | Report abuse

"the era in which the government's major commitments are the dominant issue is (largely) over"

I'm not sure I buy this premise, even, though. I don't think the Affordable Care Act fills the final hole. What about affordable housing and access to (currently overcrowded) homeless shelters? What about long-term care for the mentally ill?

As we become more prosperous as a nation, there is more that will shift from the "want" category and into the "need" category. Access to the Internet is a good example of that. 20 years ago, no one would have thought that affordable Internet access should be a basic right guaranteed by the government. 20 years from now, I think it will be taken for granted.

Posted by: madjoy | January 24, 2011 11:25 AM | Report abuse

What a bunch of crap.

US Spending

1996 7838.5 19.91 a
1997 8332.4 19.22 a
1998 8793.5 18.79 a
1999 9353.5 18.20 a
2000 9951.5 17.98 a
2001 10286.2 18.11 a
2002 10642.3 18.90 a
2003 11142.1 19.39 a
2004 11867.8 19.32 a
2005 12638.4 19.56 a
2006 13398.9 19.82 a
2007 14077.6 19.38 a
2008 14441.4 20.65 a

Yep, about 19%.

2009 14258.2 24.67 a
2010 14623.9 25.44 b
2011 15299 25.06 b
2012 16203.3 23.17 b
2013 17182.2 22.79 b
2014 18192.6 22.87 b
2015 19190.4 22.85 b

Yep, about 23.5%.

Massive, massive, spending increase in terms of GDP.

Posted by: krazen1211 | January 24, 2011 12:45 PM | Report abuse

Dare you own the fact that you have controlled and corrupted American education for decades and thusly reduced whole generations of Americans to sexualized, selfish, and stupid narcissists? Nah - THAT'S the Rights fault.

Posted by: cartmaneric | January 24, 2011 1:05 PM | Report abuse

So the current US budget isn't too big; we need this spending; and maybe a bit more?

Ok, so we'll keep spending 1/4 of the GDP of the nation... but we aren't taxing 25% of the total GDP of the nation...

Actually, just to finance our current debt we'll need another trillion dollars a year by 2020 (per the CBO)...

But hey; people will love 40% taxes on every dollar earned; it's what people want. Or will we wait for enough debt to drive that up to 50%?

Oh, and add in state taxes, sales taxes, etc. We're just talking Federal Taxes here. Ezra is convinced you'd be willing to hand the government half of every dollar you'll make for the rest of your life; so long as that government also makes purchasing choices for you; forcing you to buy approved health insurance, etc.

Maybe he's right. Maybe US Citizens love to hand over their money to get less choices and higher costs in return... that doesn't seem like something I'd be willing to pay for; but I'm clearly not in the majority here.

If I force you to buy a specific brand of food products; can I charge you twice as much for this service limiting your choices? Or is this only considered a benefit when the Government does it?

Posted by: gekkobear | January 24, 2011 1:15 PM | Report abuse

madjoy wrote:

"I'm not sure I buy this premise ...I don't think the Affordable Care Act fills the final hole. What about affordable housing and access to (currently overcrowded) homeless shelters? What about long-term care for the mentally ill?"

And what about access to university education? In many developed nations higher education is universal and funded by the state. I don't see the U.S. avoiding this debate for much longer.

Posted by: Modicum | January 24, 2011 8:05 PM | Report abuse

Modicum, agreed. Pre-k, too.

Posted by: madjoy | January 25, 2011 4:46 PM | Report abuse

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