The thing about government is that it works great when people are smart about it, but it works terribly when people aren't. The ACA should have just been optional expansion of Medicare for all, and that's it. This would have created far fewer stupid regulations that the ACA did (like business incentives and website exchanges), while increasing competitiveness for everybody and insuring everybody at cheaper costs. But we can't have that because America is afraid of taxes. We have so many stupid fucking regulations because politicians can't be seen raising taxes, so they have to get revenues through convoluted means. In Washington state, for example, we have probably hundreds of different fees for most activities. These fees keep going up and they're organized through bureaucracies, which make them overall more expensive and are a boon to special interests. We have this because this stupid voters passed a stupid law that the legislature can't raise taxes with a majority vote. So now we pay more money in overall fees than if we simply let taxes be raised or lowered based on what the people/state want/need

People who want small government defeat their own efforts when they don't acknowledge that taxes aren't the devil. If we want small government, we need a highly efficient and sufficient tax code