In their ambition to simultaneously reformulate almost every major government program, Republicans have embraced an agenda of greater complexity and scope than anything Democrats now promote. An America in which the federal government can successfully run Medicaid but can’t build functional exchanges has no place for Ryan’s far-reaching reforms.One of the advantages of simple and universal programs is that they are easy to administer. When you have a country of 300 million people, it is not trivial to figure out who is entitled to benefits.
Ironically, the sort of reforms where we match people more precisely to benefits are precisely the reforms that require really good government in order to work.
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