Make government simple again

One of the signature features of modern life is stressing out over paperwork. Some of it probably can't be avoided (buying a car, for instance) but a lot — especially anything connected with government programs — unquestionably could.

That hassle and stress is to a great degree the result of the pointless and counterproductive complexity built into nearly every government program. In the future, let us make government simple — reforming programs to make life easier instead of more burdensome.

The signature government-related experience for the average citizen is filing one's taxes, and it's a gigantic pain in the neck. It doesn't have to be. For the overwhelming majority of citizens, the IRS already has all your income data. They could send you a completed tax return you could check for errors and then send back — like many wealthy countries do. It would be easy and cheap.

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But that's only for starters.

Take education. For most children from K-12, people pay into a universal public school system. But when it comes to college, we have partially government-supported schools, topped up with a hellish maze of subsidized loans and grants, and the world's dumbest tax-advantaged savings account for parents. How about decent public and community college (where the vast majority of students go) paid for with taxes?

Retirement is a similar problem. We load tons of responsibility on individuals, who are supposed to use tax-advantaged accounts like the 401(k) to save and invest in one of a slew of complicated mutual fund plans. Unsurprisingly, it does not work for most people. Instead it mainly fuels a cottage industry of swindlers who trick people into high-fee plans. How about instead we expand Social Security, paid for with taxes?

Or take health care. The whole health-care industry could not possibly exist without the elaborate network of government regulations, subsidies, and programs that backstop it at every point. Yet the amount of complexity this system dumps on the citizenry is simply brain-melting.

About half the country has insurance through an employer — the creation of a huge government tax subsidy. Even when private insurance is pretty good, simply accessing care is often a terrific hassle. You've got to make sure you've got the right sub-sub program (BlueCard PPO/EPO? Or PPO Basic? Or Traditional?), and then find a provider that takes the insurance. Then, assuming you're not bleeding out, you'd be well-advised to make sure the provider doesn't contract with out-of-network specialists, because they probably won't tell you on their own. After you've received care, then you can look forward to the inevitable fight between you, the insurance company, and the provider over who is going to pay the outrageously inflated prices.

Health Savings Accounts (HSAs) are even more obnoxious. Josh Barro detailed the experience of using one of these, only to get his money cut off after finding out that he was supposed to be uploading receipts from certain providers into some website. Instead, he had thrown them away:

Or take Medicaid. This is certainly simpler than most private insurance, especially when it comes to payment. But determining your eligibility for the program is a nightmare in most states. It may depend on whether the state took the ObamaCare Medicaid expansion, your income, your family size, whether you are disabled, and other facts. That's a big part of why many people who are eligible don't even realize it.

Even Medicare has been larded up with all manner of unnecessary garbage over the years. There are four different parts to it: Part A and B, which cover most usual medical services; Part C (or Medicare Advantage) which gives four different sub-options (HMO, PPO, fee-for-service, or special needs) to get Part A and B through a more expensive private vehicle; and Part D, which covers prescription drugs. Then there are various premiums and deductibles, depending on one's income and whether you're also eligible for Medicaid.

Finally there are, of course, a zillion exceptions and qualifiers, especially around vision and dental coverage. Companies sell "Medigap" policies to plug some of these holes.

There is no real point to any of this nonsense. It's just neoliberal cruft that's built up over the years. For reasons of simplicity, I have often referred in articles to a national single-payer plan as "Medicare for all." But if we really were to do such a national plan, all those various sub-programs would be trashed, and everyone would be enrolled in a single simple program that covers all necessary medical treatment with no cost-sharing, period.

The expectation behind this horrible situation seems to be that everyone needs to "take responsibility" for every part of their lives, and become a hobbyist in investing, tax law, medical billing, and so forth. But there's no shame whatsoever in paying taxes to offload all those tasks onto the government. I for one have better things to do than fill out forms until my retinas bleed.