Why We Need More, Not Less, Government

In the face of increasing threats to our wellbeing and the inability of the market or individual efforts to effectively address them, we need to expand public sector programs.

For decades, conservatives have been pushing for smaller government, and have consistently called for reduced social spending, less regulation, and more tax cuts. But not everyone agrees. When the financial crisis hit in the fall of 2008 and the economy began to melt down, suddenly there were calls for bigger and more active government. Many people wanted a massive federal stimulus plan to ward off an economic depression, and others demanded the widespread re-regulation of financial markets to prevent a recurrence of these problems.

On top of this, many Democrats have argued for increased government involvement in a wide variety of areas, ranging from education and energy development to infrastructure repair and health care reform. But is this broad expansion of the public sector really justified?

Whether we need more government in this country really depends on the answer to three other questions. First, is there room for improvement in government programs? Have we reached the limits of what government can do in most policy areas, or could expanding these current programs produce significant added benefits for the public? Second, are any of our current social and economic problems worsening? Are we facing new and serious threats to our wellbeing? If so, this would logically indicate the need for more government. And finally, can we rely on markets and individual effort to solve these current and emerging problems? If so, then we don’t need more government. But if markets and individual initiative are not up to the task, this bolsters the case for a more collective, governmental approach. All three of these questions are complex ones, but as this article will show, we can begin to get some definitive answers to all of them. These answers strongly indicate that we do need more government – not less – in the United States.

Room for Improvement

As impressive as the accomplishments of government are in the U.S., there is clearly room for it to play a much more constructive role in people’s lives. In fact, many Americans sense this already. One of the most common complaints about government is that it is not doing enough to address a whole raft of problems. Sure the air is cleaner than it was, but we still have major smog problems in many cities. Of course we have done much to reduce poverty among the elderly, but a high level of poverty among the general population still exists. And while energy efficiency has improved, we still have an economy that is dangerously dependent on oil and other fossil fuels. Some may be tempted to conclude from these situations that government simply can’t do anything more to help – that we have reached the limits of what government can do in these areas. But this is not the case. We know that government could actually do much more. How do we know this? Because governments in many other advanced democracies have already done much more to effectively address these problems.

In another article, “Government’s Forgotten Achievements,” I cited a study done by Derek Bok which showed that a myriad of government programs have in fact been successful in addressing many of our social, environmental, and economic problems. But this study also found that there is considerable room for improvement. Bok discovered this by comparing the accomplishments of the U.S. in important policy areas to the accomplishments of the government of other major democracies – primarily those in Western Europe. What Bok found in this comparative study was not comforting: “Over the past several decades, America has moved ahead more slowly than most other leading countries in most areas of activity that matter to a majority of the people.”1 Of the more than sixty areas examined, the efforts of the U.S. government were below average in two-thirds of the cases, and at or near the bottom of the list in more than half.

Among the areas where we have under-performed other democracies:

Growth of per-capita income.

Gender earnings gap.

Reducing pollution.

Income inequality.

Cost of health care system.

Coverage of health care system.

Life expectancy.

Access to affordable long-term health care.

Infant mortality.

Job-related illness or injury.

Effective job training.

Safeguards for laid-off workers.

Ability of workers to establish unions.

Number of families in poverty.

Severity of poverty.

Affordability of owning a house.

Affordable rental housing.

Crime rates.

Segregation by income and race in cities.

Student performance in math and science.

Availability of child care.

Child nutrition.

Children enrolled in pre-school.

Availability of parental leave.

 

The fact that we lag behind our democratic neighbors in so many policy areas demonstrates unequivocally that our government could accomplish even more than it has done already. There is a real possibility that increased government efforts could do much more to improve our lives in significant ways. The greater success of other democratic governments in addressing serious economic and social problems shows that it can be done and that we could be following their lead.

 

 

We Can Do Better at Fighting Poverty

Let’s consider just one particular policy area, poverty, where we lag far behind other democracies. We have an abysmal record in reducing the level of poverty in this country. It went down in the 1960s, but for the last 40 years it has hovered stubbornly at around 11-13%. Today, over 43 million Americans continue to suffer severe economic hardship. Conservatives consider our failure to reduce poverty as evidence of the inherent limitations of government. They conclude (wrongly) that since our current anti-poverty policies have failed, that there is nothing the government can do and that it should get out of the business of trying to eliminate poverty. It is this attitude that has animated Republican attempts to cut back on programs for the poor, such as welfare and job training. For them, our failures in poverty policy only contribute to the case they are making for a more limited government.

But the record of fighting poverty in Europe clearly demonstrates that governments are quite capable of addressing poverty much more effectively. Anti-poverty policies in the U.S. only lift 36% of people out of poverty, while government policies reduce poverty in Germany by 76%, by 83% in the Netherlands, and by 89% in Sweden.2 Not surprisingly, all of these other countries end up with much lower rates of poverty. While our poverty rate continues to hover around 12%, Germany, the Netherlands, and Sweden have reduced their poverty rates to 4%, 4% and 2% respectively.

These are very impressive differences. And it is not a mystery how these other countries have been more successful in addressing poverty. First, these countries simply spend more on helping people out of poverty – welfare payments are higher, unemployment benefits are more generous and last longer, and so on. Spending more money helps lift more people out of poverty. In addition, social welfare policies in these other countries are much more universal – they include everyone, not just limited groups. Everyone has national health insurance; everyone qualifies for day care subsidies, and so on. Because of this, the social safety net is much more complete and effective than in the U.S., and this means that fewer people are likely to slip into poverty because of personal disasters such as a serious illness, a divorce, or the loss of a job. Most other democracies also pursue policies that help to raise wages. They encourage rather than discourage the formation of unions and they set a much higher minimum wage – both of which help to lower the number of the working poor in these countries.

As Bok found, poverty is just one of dozens of areas in which the U.S. lags behind other Western democracies. Clearly our government could be doing much more to address a wide variety of problems and could make even greater strides in improving the lives of Americans. This fact by itself is a powerful argument in favor of more government in the U.S.

Things are Getting Worse

The case for more government is strengthened even more if it can be shown that some of our current problems are worsening and/or that we face significant new threats to our quality of life. In the wake of the 9/11 attacks, few Americans disagreed with the idea that we needed major new government initiatives to deal with the growing menace of terrorism. Likewise, it also makes sense that we would need more government if we are facing other worsening problems. And in fact we are. Let’s just consider a few of them.

  • Growing Economic Insecurity. The effects of the deep recession continue to linger for many families. Long-term unemployment has become chronic and is at its highest rate since the Great Depression in the 1930s. Add to this the millions who can only find part-time work, and we have more than 40% of Americans who want a full-time job but cannot find one. A Rockefeller Foundation report found that over 20% of Americans have experienced a drop of more than 25% in income. The bottom line is that more and more families are facing economic disaster: out of a job, their savings gone, and nowhere to turn for help.
  • Unsafe Food. The last decade saw increasing threats to our food system. Problems have ranged from e. coli infected beef and peanut butter to tainted spinach and botulism-laced chili sauce. Every year seems to bring new instances of Americans getting sick and dying from the food they eat.
  • Financial System Breakdown. Deregulation and lax enforcement allowed the financial industry to operate with little public oversight. One disastrous result was the mortgage loan crisis that eventually wiped out billions of dollars of investors' assets and brought on a severe recession. The 2010 financial reform bill addressed some of these issues, but many crucial proposed regulations were blocked by the fierce lobbying of the financial industry. The bill left in place two of the main causes of the financial crisis: the ability of banks to engage in high-risk speculation, and the use of dangerous derivatives like the credit-default swaps that led to the collapse of AIG. The financial system is still at risk.
  • Health Care Crisis. There is almost universal agreement that the U.S. health care system is increasingly in crisis. Tens of millions have been uninsured and costs have been spiraling out of control. Amazingly, the elderly must spend a larger proportion of their income on their medical expenses today than they did in the early 1960s before the passage of Medicare.3  The 2010 health care reform bill did address the issue of lack of access for many Americans. But whether this bill will rein in the growth of health care costs is very doubtful. Many experts believe that new significant policy changes are necessary to address this cost issue.
  • Growing Environmental Problems. A number of environmental problems are getting worse. The most obvious one is global warming, which will bring with it extensive coastal flooding, agriculture crop declines, rising danger from tropical diseases, increasingly severe weather, and so on. But there are also other environmental issues that are getting worse rather than better. Consider the plight of U.S. fisheries. Over-fishing has resulted in disastrous declines in fish stocks off New England, the Gulf of Mexico, and other areas. Increasing toxic waste from discarded computers and other electronics is another emerging problem.
  • Increasing Economic Inequality. The rich are getting richer and the poor are getting poorer and the middle class is shrinking – all threatening to further divide American society along class lines. Income inequality is getting worse. Between 1979 and 2009, the incomes for the richest 5% of families grew by a whopping 73%; and incomes for the richest 20% by an impressive 49%. But the increases for the bottom 60% of families have been pitiful in comparison – their gains were a meager 7%. Today over half of all income in this country (50.3%) goes to the top fifth income class of families. The income going to the top 5% of richest families is actually more than the combined income of the bottom 40% – the 110 million Americans living on low and moderate incomes. The inequalities in wealth are even larger – with the top fifth richest families owning a staggering 84.7% of all the wealth of the country, the next 40% owning only 15.1%, and the poorest 40% owning less than 1%. Most other Western democracies have a much fairer distribution of income and wealth. In Sweden, for example, the poorest 40% own 32% of the wealth.
  • Crumbling Infrastructure. Around the country, crucial infrastructure facilities – roads, bridges, sewers, etc. – are rapidly deteriorating. For example, 27.5% of the nation's bridges (162,000) are structurally deficient or functionally obsolete. In addition, the nation's 16,000 wastewater systems face enormous needs. Some sewer systems are 100 years old and many treatment facilities are past their recommended life expectancy. Currently, there is a $12 billion annual shortfall in funding for these infrastructure needs. Also, airport capacity increased only 1% from 1991 to 2001, yet air traffic increased 35% during that same period. The American Society of Civil Engineers argues that we must dramatically increase funding to solve these and other infrastructure problems – and it estimates that it will take at least $1.6 trillion to bring these facilities into an acceptable state.4
  • New Disease Threats. A whole host of new and evolving diseases now threaten public health in the United States. They range from the Hantavirus to new drug-resistant strains of microorganisms. Globalization and tourism mean that new diseases are more easily finding their way into this country. The West Nile virus and eastern equine encephalitis have already arrived. The main concern now is that a more virulent and deadly form of swine-flu or bird-flu is going to eventually come to the United States, with potentially devastating results.
  • Cyber Security Threats. Threats in cyberspace have risen dramatically in the last 15 years. Individuals are vulnerable to viruses, worms, financial scams, and identity theft. Embezzlement, fraud and other cyber crimes cost businesses billions of dollars a year. More importantly, key parts of the economic infrastructure are vulnerable to cyber attack, including the banking system, the telecommunications system, and the electricity grid. Cyber-attack tools are spreading rapidly worldwide and are being employed by foreign nationals and foreign intelligence services. Cyber warfare and cyber terrorism are very real threats to our national security.
  • Looming Retirement Crisis. Social Security is in good shape at least for the foreseeable future. But the other two forms of support that retirees hope to rely on – private pensions and private savings – are in terrible shape for most people. Fewer and fewer companies are offering fixed benefit pension plans, and it is estimated that U.S. companies are underfunding current pension plans to the tune of $350 billion – a disaster waiting to happen. Stagnant wages have made it difficult for many workers to save any money for retirement: 36% of workers contribute nothing to their retirement and 43% have less than $10,000 saved for their "golden years." As a result, many Americans will be facing poverty – or at least a much lower standard of living – when they retire.
  • Deteriorating Public Education System. Many local public school budgets are in crisis, with teachers being laid off and textbooks in short supply. There is a growing divide between the quality of public education offered in rich communities and that in poor communities. Due to either aging, outdated facilities, severe overcrowding, or new mandated class sizes, 75% of our nation's school buildings remain inadequate to meet the needs of school children. State colleges and universities -- which produce three quarters of all degrees in the United States – are also in trouble. Class sizes are spiraling, and needed maintenance is being neglected. In addition, states have been raising their tuitions and cutting financial aid. A study by the National Center for Public Policy and Higher Education gave the public college and university systems in 43 states a grade of “F” for affordability.5 This means that many low- and middle-income students simply cannot afford college anymore – a half million were turned away for lack of money in 2004 alone.

The existence of these and other growing problems clearly justifies the expansion of public sector efforts to deal with them. And increasingly, many Americans have realized that more government action is necessary in many of these areas. A 2010 poll found that when people look ahead 10 to 20 years, they say by 42% to 18% that the federal government will become more rather than less important in terms of improving the lives of the American people.

 

 

Can Markets Substitute for Government?

Of course, even if we have serious social, economic, and environmental issues facing us, this may not necessarily require more government. There might be better, non-governmental ways to solve these problems. Conservatives have long maintained that we would be better off relying on the market or on individual efforts, rather than government. Let’s consider both of those claims.

First, can the market really solve most of these problems? There are several reasons to be skeptical of this claim. First, as was discussed in some detail in the article “Capitalism Requires Government,” many of our country’s current problems are in fact caused by our market-based economy. Free-market economies are incredibly productive, but they inevitably bring with them a whole host of social and economic troubles. Clearly issues like poverty and increasing economic inequality are directly traceable to how the market distributes income and wealth. Our looming retirement crisis is due in large part to the effort of businesses to increase profits by abandoning their traditional pension programs. And there is a good deal of evidence to indicate that our health care system is overly expensive in large part because we rely so much on the private sector for insurance. As these examples illustrate, the market is often the source of our problems, not the solution.

It is also clear that we cannot depend on markets to solve their own problems. Conservatives and libertarians are fond of arguing that markets are "self-correcting." If we would just leave them alone and not burden them with onerous regulations, they would correct their own problems. This is one of the core assumptions underlying the push for the deregulation of markets that has been a hallmark of the Republican Party. But in recent years, we have seen that this idea of self-correcting markets is often more myth than reality.

 A good example of how markets do not fix their own problems is the food supply system. In the last decade, we have seen one food safety problem after another, including contaminated spinach, E. coli infected beef, and salmonella tainted peanut butter. These problems have sickened tens of thousands of Americans and in some cases have led to death. Many food businesses have little incentive to adopt costly safety standards, in part because they know that in many cases it is difficult to trace the sources of food-borne illnesses. The food industry has claimed that it can rely on private food inspectors, but these auditors are hired by the very companies they inspect and have often failed to point out problems in facilities. In the case of peanut butter, the offending plant had gaping holes in the roof and walls, was infested with rats and roaches, and had employees washing mops in the same sinks as peanut butter production equipment. And yet the private inspector reported that "The overall food safety level of this facility was considered to be: SUPERIOR." After the salmonella outbreak was made public, that inspector told a food safety expert: "I never thought that this bacteria would survive in the peanut butter type environment. What the heck is going on?"

Another classic example of markets failing to correct themselves is the mortgage loan fiasco and the resulting economic crisis. For years conservative had been working hard to de-regulate the financial industry. They asserted that regulations did more harm than good. In 2006, Bush Treasury Secretary Henry Paulson argued that "the solutions to our nation’s problems are not always found in Washington." And he maintained that one of the two main threats to financial markets was "excessive regulation."

 Other conservatives argued that any regulation of financial markets should be "voluntary." As traditional financial regulations were being stripped away, right-wing analysts insisted that Wall Street could be relied on to police itself and thus protect the public interest. We now know that this was wishful thinking. Even Bush's head of the Securities and Exchange Commission, Christopher Cox, had to admit in the fall of 2008 that "The last six months have made it abundantly clear that voluntary regulation does not work."6

These are just two examples of why we can't rely on markets and business to solve society's problems. There are plenty more. Past experience has shown that corporations will not always provide safe working conditions or livable wages, that private schools cannot ensure that all our children get a decent education, that companies will not clean up their pollution on their own, and that “let the buyer beware” is not going to protect us from dangerous products. No – if we want to address these kinds of problems, there is really no alternative to public sector programs.

Can Individual Efforts Substitute for Government?

The other alternative that conservatives offer to more government is more effort on the part of individuals. They argue that we need to empower individuals to take responsibility for their own problems, and thus reduce their dependency on government. This was the principle behind a major set of Republican initiatives that they called the “ownership society.” Policies like 401(k) retirement plans, individual health savings accounts, privatized Social Security, and private education were seen as ways to allow people to take control of their own fates and solve their own problems. As a leading libertarian intellectual, David Boaz, has explained it:

An ownership society values responsibility, liberty, and property. Individuals are empowered by freeing them from dependence on government handouts and making them owners instead, in control of their own lives and destinies. In the ownership society, patients control their own health care, parents control their own children's education, and workers control their retirement savings.7

This may sound good to some people, but the record of these kinds of programs does not inspire much confidence. Consider, for example, how 401(k) plans have helped to solve the retirement crisis. The 401(k) option has been around for decades and so it is a good test for this approach to retirement security. Unfortunately, it is flunking that test. On the one hand, these plans have been a boon for businesses. They have been able to greatly reduce the money they spend on retirement for their employees. They no longer have to invest in fixed benefit pension plans. Moreover, most donations to these 401(k) accounts come from the workers themselves. Mutual funds firms have also benefited from these accounts as well. But most workers don’t seem to be getting much security from them. First, only half of the American workforce even has access to these accounts, and only 40% of those feel that they can afford to contribute to one. Also, the vast bulk of the money contributed to these plans comes from already well-off employees – not your average worker. The myth is that the average worker now has tens of thousands of dollars in these funds ready to provide for a comfortable retirement. But in reality, the median amount of funds for these account holders – what’s most typical – is a mere $13,000.8

As Jacob Hacker has explained, despite the growth in the total funds in these accounts – especially during the 1990s stock market boom – most workers are actually worse off in terms of their retirement prospects than they were before.

To be sure, defined-contribution accounts [401(k)s] grew handsomely during this period, especially in the 1990s. Yet, at the same time, median defined-benefit holdings [pensions] declined as employers stopped offering defined-benefit programs. So too did expected Social Security benefits, thanks to the cutbacks in Social Security passed in 1983. When all the gains and losses are added up, the median family approaching retirement – that is the family exactly in the middle of the retirement wealth distribution – ended the 1990s with 11 percent less in retirement wealth than the median family had in 1983.9

Today, of course, the situation for 401(k) accounts is even worse. In the stock market collapse that followed the mortgage loan crisis, workers lost billions of dollars in these accounts. Many people had to put off retirement. Those already retired were threatened with poverty and many were forced to try to find work again. And imagine how much more dire this situation would be if the Republicans had had their way and we had privatized Social Security and allowed people to invest this money in the stock market.

Clearly, as companies rapidly retreat from providing people with reliable retirement plans, individual efforts, like 401(k) accounts, are not going to be able to provide the kind of economic security that most people need as they grow old.

Health Savings Accounts (HSAs), another much vaunted approach being push by the Right, are also doing little to help with the ever growing problems of health care in the United States. In this approach, individuals buy health insurance plans with very high deductibles – such as $2,000 – and then make up the difference in money they save in their own HSAs. But despite a big push by Republican lawmakers and corporations, polls show that most people don’t like this approach and would rather have regular, low-deductible health insurance. These plans mostly appeal to the wealthy (who can afford high out of pocket expenses) or the young and healthy (who don’t need much care). However, draining these people out of the traditional health insurance programs means that premiums will have to go up for the less well-off and the less healthy people in this insurance pool. In addition, when average Americans are forced into these plans, they can often run into trouble. Studies have shown that HSA users are much more likely than those with traditional medical coverage to have trouble paying their medical bills. They are also much more likely to avoid or postpone treatment for serious medical problems because of the cost.10

 

  

Shifting Risks from Society to Individuals

But there is a deeper problem with the individualistic approach – one that goes beyond the inadequacies of these particular programs. The whole “ownership society” approach is actually a way of shifting economic risks from businesses and government on to the backs of individuals. It makes us responsible for dealing with all the significant financial risks that we face in an advanced capitalist society – getting sick, retiring, becoming disabled, losing our job, and so on. But in fact, individuals are usually the least able to deal with these risks – and that is why we have used government to create all sorts of “social insurance” programs (like Social Security and Medicare) to spread these risks among society as a whole and create more economic security for all of us.

Jacob Hacker has written an entire book about this topic, called The Great Risk Shift. In it, he gives an eloquent description of why we originally embraced the government-based, “social insurance” approach back in the 20th century. He explains the basic political and economic insights that led to the creation of Social Security and other collective efforts to deal with common risks:

Social insurance transformed individual misfortunes into common problems. It made the inevitable dislocations of capitalist society into risks that could be managed and distributed, rather than blows of fate that could only be feared and suffered. The ‘insurance” in social insurance came from the power of aggregation: Risks that could devastate an individual or community could be managed if they were spread across many individuals and many communities. The “social” in social insurance came from the principle of shared fate, the reassurance that “we are all in this together.” All insurance pools risks. Only social insurance pools risks on terms that enable the poor as well as the rich, the aged as well as the young, the ill as well as the healthy to afford protection. The crafters of the Social Security Act believed that insurance had to be available and within the means of those who needed insurance most.

At the heart of this belief was a simply conviction: broadly distributed threats to economic well-being – sickness, injury, disability, unemployment, penurious old age – were not the responsibility of individuals alone. They were a widespread and often unavoidable feature of an interdependent industrial society. And because they were, the cost of these risks should be distributed widely across the citizenry, not concentrated on those unlucky enough to experience them – a goal made possible by the unique power of government to compel participation and require contributions. Government could pool the risks of millions of citizens. It could guarantee that even workers of limited means are able to afford basic protections.11

 

As Hacker makes clear, social insurance programs are one of the greatest inventions of modern democratic government and they have gone a long ways toward making all of our lives much more secure. We could be doing even more with social insurance programs, as they have done in Europe, but it is this proven approach that has been directly under attack by conservatives. They want us to move from a “we are all in this together” society to a “you are on your own” society. But this individualistic, anti-government approach cannot provide the kind of economic security that most Americans need and want.

Public Support for More Government

            Many Americans are aware of the serious problems we face as a country and say they want more government involvement to help solve them. For example, over 60% of Americans say that they want the government to spend more on education and health, 69% favor more generous government aid to the poor, 77% say the government should do all it takes to protect the environment, and 83% favor raising the federal minimum wage. And with numbers like these, this is clearly not just liberals talking. There have to be a lot of moderates and even conservatives that recognize the need for more government in these areas. In fact, a 2010 poll by the Center for American Progress found that 40% of conservatives and libertarians support a larger federal government role in areas like improving public schools, reducing poverty, and developing new energy sources.12

Only More Government Will Do

To sum up, there is a great deal of evidence that strongly suggests that Americans would be better off with more – not less – government. We know from the experience of other advanced democracies that our government could be doing more to address many of the problems we face as a society. We also know that some of these problems are getting worse, and other additional serious problems are emerging. Finally, it is clear that non-governmental approaches – markets and individuals efforts – are in many cases not sufficient to deal with all of these problems.

Of course all of this does not tell us exactly what new kinds of public efforts are needed. We still need to carefully analyze proposed policies and programs to figure out which ones will be most effective in addressing these social, economic, and environmental problems. And there is also the difficult question of deciding how much we can afford to spend to alleviate these problems. As the article on the deficits makes clear, we can afford to spend a lot more on these problems than conservatives say we can. But this still leaves the question of how much we want to spend. In any case, one thing that we do know for sure at this point is that if the government does nothing more, or actually does less, our quality of life is going to suffer. In today’s world, we need a well-funded public sector that will do more to reduce the risks we face and to improve the lives of all Americans.

 


1. Derek Bok, The State of the Nation (Cambridge, MA: Harvard University Press, 1996)p. 387.

2. Timothy M. Smeeding, Lee Rainwater, and Gary Burtless, “Luxembourg Income Study working Paper No. 244: United States Poverty in a Cross-National Context,” (Differdange, Luxembourg, Luxembourg Income Study, 2000).

3. Jacob S. Hacker, “Privatizing Risk without Privatizing the Welfare State: The Hidden Politics of Social Policy Retrenchment in the United States,” American Political Science Review, Vol. 98, No.2, May 2004, p. 253.

4. American Society of Civil Engineers, "Report Card for America's Infrastructure: 2003 Progress Report," http://www.asce.org/reportcard/index.cfm

5. National Center for Public Policy and Higher Education, “Measuring Up 2006: The National Report Card on Higher Education. http://measuringup.highereducation.org.

6. The Paulson and the Cox quotes are from OBM Watch, The Bush Legacy: An Assault on Public Protections, http://www.ombwatch.org/node/3877

7. David Boaz, “Ownership Society Defined.” http://www.cato.org/special/ownership_society/boaz.html

8. Jacob Hacker, The Great Risk Shift (Oxford: Oxford University Press, 2006) p. 122.

9. Ibid.

10. Think Progress, “Health Savings Accounts Fail to Provide Savings or Address Costs.” http://thinkprogress.org/2006/01/31/sotu-health-savings-

accounts-fail-to-provide-savings-or-address-costs/

11. Hacker, The Great Risk Shift, pp. 41-42.

12. Guy Molyneux and Ruy Teixeira, with John Whaley, "Better, Not Smaller: What Americans Want from their Federal Government," July 2010. http://www.americanprogress.org/issues/2010/07/what_americans_want.html