Insofar as it works at all, Big Government works best in small, highly developed, northern Continental nation-states with a sufficiently homogeneous population to have sufficiently common interests. You can get by with it for a while in Mediterranean Europe, mainly because of a somewhat desultory attitude to the rule of law: In Italy and Greece, there are prohibitions against everything, but nobody obeys them and so, after a fashion, life goes on. Anglophone nations are generally disposed to abide by the law, and so, if there are a bazillion regulations, the average citizen will make a sincere effort to comply. But if you’re, say, Australia and you’re attempting to design a health-care system for 20 million people across an entire continent, it’s just about doable.
But no advanced society has ever attempted Big Government for a third of a billion people — for the simple reason that it cannot be done without creating a nation with the black-hole finances of Stockton, Calif., and the Black-Hole-of-Calcutta fetid, airless, sweatbox utility services of Rockville, Md. Thanks to Obamacare, in matters of health provision, whether you’re in favor of socialized medicine or truly private health care, Swedes and Italians are now freer than Americans: They have a state system and a private system, and both are relatively simple. What’s simple in micro-regulated America? In health care, we now have what’s nominally a private system encrusted with so many statist barnacles that it no longer functions as either a private or a state system. Thus, Obamacare embodies the strange no-man’s-land of statism American-style: The U.S. is no longer a land of republican virtue and self-reliant citizens but it’s not headed for the sunlit uplands of Scandinavia, either.