Bigger Doesn't Always Mean Better

I grew up in a small town of less than 4,000 people. It’s total land mass encompassed one square mile, and it contained two schools – one public and one parochial – and five churches. There were a couple of drug stores, a pair of pizza shops, and a single gas station. For whatever reason, there were two dry cleaners plus a Chinese laundry, but only one supermarket. To satisfy your sweet tooth, you could visit Gall’s bakery or Aunt Charlotte’s candy store. Gall’s closed down years ago, but Aunt Charlotte’s is still thriving, owned and operated by the same family now in its third generation.

I wouldn’t change my childhood growing up in small town America for anything. I could walk to the local community center to play pick-up baseball or basketball or ride my bike to the public library to take out some books. After school, we played kickball or freeze tag in our backyard or in the street… and when a car interrupted our game, we chanted “Car, car, C-A-R, stick you head in a jelly jar.”

So, I guess it’s only natural that when I got older, I gravitated to small towns to live in, small non-profit organizations to work for or run, and small churches to attend. For 22 years, Deanna and I were members of an independent Bible church that averaged about 120 people. Our kids literally grew up there – starting in the church nursery, progressing to Sunday School and Awana, and eventually youth group. Everybody knew everybody, so you were immediately aware if someone wasn’t there on Sunday morning due to an illness. That meant a phone call and an offer of a hot meal or free babysitting while you got some much-needed rest.

In other words, we were family… something that is often missing in much larger congregations where the teaching may be great and the programs may be expansive, but intimacy and accountability may be lacking.

That’s a perfect segue into my main topic for today, which is the lack of accountability in our bloated and oversized federal government. The Affordable Care Act, otherwise known as Obamacare, is a prime example.

On Wednesday, the Government Accountability Office published a report addressing fraud in the Affordable Care Act. Titled, “Patient Protection and Affordable Care Act: Preliminary Results from Ongoing Review Suggest Fraud Risks in the Advance Premium Tax Credit Persist”, the report was a searing indictment of government fraud, incompetence, and inefficiency.

Among its findings…

“Preliminary results from GAO's ongoing covert testing suggest fraud risks in the advance premium tax credit (APTC) persist. The federal Marketplace approved coverage for nearly all of GAO's fictitious applicants in plan years 2024 and 2025, generally consistent with similar GAO testing in plan years 2014 through 2016.”

In other words, fraud risks that were first reported in 2014-2016 have yet to be corrected 10 years later!

In 2023, there was more than $21 billion in premium tax credits that the IRS couldn’t match to filed tax returns, meaning that money was likely issued to ineligible people or in the wrong amounts. That same year, about 58,000 people were flagged as deceased who still appeared to have had subsidies paid on their behalf, roughly $94 million in total.

Is your blood boiling yet?

There were also 29,000 instances of the same Social Security number being used across multiple plans, including one extreme case where a single SSN was tied to more than 125 policies.

Fraud and waste on steroids… and no one seems to care, let alone do anything about it. That’s what happens when things get big and bloated. Accountability goes out the window and corruption comes in the door.

Obviously, there is no simple solution to the problem, not in a country of 330 million people. But a good start would be to shift as many government programs as possible from the federal level to the state level… and from the state level to the county and local levels.

The best gifts often come in the smallest packages, and government always operates the most efficiently and effectively when it’s closely monitored by the people it serves.