Most Americans love the idea of “bigness.” Bigness alone seems to have its own virtue. Idiosyncratically, we will drive out of our way to see the world’s largest ball of twine or the tallest building or the most mammoth stadium. More significantly, we strive to have the largest banks, the biggest car companies, the greatest oil companies and most extensive retail chains. We are impressed by size.
Yet we know better than to equate size with quality – in fact we know that the bigger something gets, the harder it is to deliver quality. With almost no exception, once beyond an optimum size (which varies with the nature of the enterprise) the quality of the operation and the product always declines. Sadly, not only does quality decline but the costs per unit of output start increasing.
Worse yet, as things expand beyond their natural limits, they tend to collapse. Excessive size creates instabilities. Everything from balloons to Fortune 500 companies go “POP!” when they expand beyond their structural competency. This is as much a truth of management theory as it is a law of physics.  
There is a political divide in America over how big the government should be. Most often the issue isn’t framed that way; rather the discussion is over the role of government, its functions and its purposes. But at its center the argument is really about the size of government. Some people think the government should be responsible for everything and others think that government should be responsible for as little as possible. The more things government is responsible for, the bigger it gets and vice versa.
For most individuals even their own positions on this issue are somewhat in flux since one’s views on the optimum size and role of government tend to vary with the degree to which people agree with the political philosophy of the current ruling government. If you don’t like the political leaders in charge, you tend to not want to give them more power.
The problem of arguing about the size of government in purely political terms is that it ignores a fundamental reality: the bigger government gets, the worse it is managed.  This is a fundamental law of the political universe. It is without exception.
In the business world it is accepted without challenge that big companies are harder to manage than small companies. “Bigness” has advantages in terms of executing strategy and gaining the benefits of scale that are often worth the increasing management difficulty, but there are many cases where the pure size of an institution overwhelms all the strategic and tactical advantages. Most successful major corporations ultimately reach a size where management of the entity constitutes the biggest single obstacle to success. Beyond a certain size (the size varies by industry and by complexity of the market), unless there is excellent management, the company will fail regardless of scale advantages or the excellence of strategy or tactics.
Because this is true, there are an almost limitless number of books and treatises on management. There are famous management gurus who preach their particular favorite management theory. There are business leaders with worldwide renowned for their management talent. They are justly admired – managing large enterprises is extremely difficult. Yet even with the management gurus at their side, and Boards of Directors that follow their lead, and legions of executives and managers who strive to do as directed, and no real challenges to their authority, and expert consultants to advise them, and a single vision shared by all, even with all these advantages, invariably corporations outgrow their management capabilities.
So let’s return to the issue of Big Government. Is it remotely possible to manage Big Government well? Let’s examine the particular management challenges Big Government faces:
    It is REALLY big;
    There is no common vision shared by all the leaders;
    Power is deliberately divided among three branches of government so that no one authoritarian leader can dominate;
    Senior Management positions are constantly being reshuffled;
    Senior Management positions are allocated on the basis of “office” politics;
    The middle management bureaucracy tends to ignore any executive mandate;
    The middle management bureaucracy is not incentivized to meet specific new objectives;
     The institution itself has no natural imperatives for survival or success.
The list could go on. But the point should already be obvious. Big government institutions suffer from virtually all the management sins that management consultants deplore. No major corporation could succeed with even a couple of the management sins listed above – let alone all of them!
It should be noted that there is one very large part of government that is well managed. That’s the military (the Army, Navy and Marines – not the Defense department.) Our armed forces are very large, but importantly they share a very different command and management structure. They are famously “top down” driven, they have a shared vision, continuous leadership and personal survival is at risk in every battle. Compare any other large government department to our armed forces and the comparison is quickly ludicrous.
Which brings us to the battle over healthcare and the “Public option.” No one who has seriously studied the issues doubts that there is waste and inefficiency in the current system – of course there is – it is a vast and complicated system that is extremely difficult to manage. Yet the idea that the government can reduce waste and mismanagement by substantially growing the system and expanding the government’s role in the management of the system is at best a politician’s pipe dream and at worst a blatant and dangerous misrepresentation (the nice word for a lie.) When a business that is poorly managed to begin with grows larger, the outcome is invariably greater mismanagement, more inefficiency and corruption and deterioration in product quality. That is a fact, not a political viewpoint.
Lastly, it needs to be stated that it is not an accident that Big Government is a management nightmare. The framers of our Constitution feared a big authoritative government and imposed all sorts of checks and balances to prevent any future “CEO” from managing effectively to a single vision with control over all branches of government. They deliberately established a political environment that would discourage government from ever getting too big. Unfortunately, our political leaders have long used their not inconsiderable ingenuity to ignore those limitations – even if it meant government institutions that are wasteful, inefficient, corrupt and contrary to the public good. In doing so, some acted out of good motives and some just aimed for personal aggrandizement, but all of them failed to respect basic management realities. In doing so they charged all Americans with breaking the fundamental law of the Political Universe: the bigger government gets, the worse it is managed.
The message here should be clear to everyone. If the government takes control over an already massive healthcare industry, don’t be surprised if it goes “POP!!!”