Only in very serious minds can these conceptions of the US government co-exist:

1. The US government is so hopelessly inefficient and incompetent, that any attempt to deliver government-provided health insurance (or the option thereof) to the uninsured (and some/all of the already-insured) is an unprecedented fool’s pipe dream of a fantasy of a boondoggle with no chance for any positive outcome.  Also, socialism. 

And at a price tag of $1.2 trillion dollars over ten years, there is no way we can afford to chase such fantastical chimera.

AND

2. The US government is so remarkably efficient and competent that it can transform (wholesale) Iraqi and Afghan societies (at the same time) and remake those societies into US-friendly, Western-conceived models of good governance, free market economics and liberal democracy all through multi-decade armed occupations.  These goals are easily attainable for a government so adept at devising and delivering effective political, economic, social service and governance measures, and resounding victory is almost certain, as long as we don’t lose our nerve and do something foolish like withdraw. 

And at a price tag of $3-4 trillion dollars over the past 8 years, the continuation of these policies at that burn rate for the next 25-50 years would be a bargain.

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