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Jay Cost writes in The Weekly Standard  The Real Price of Politics.

Excerpts:

 If the government were asked to do only what a fair reading of the Constitution authorizes it to do, this design would not be a problem. In its time, the arrangement of powers and branches was a brilliant innovation to ensure that all sides were treated fairly. A government, however, that is expected to generate economic growth, build highways and bridges, support farmers, make sure families have food on the table, provide access to health care, fund scientific research, ensure food, drug, and product safety, help kids afford college, maintain expansive and unmatched armed forces—even put a man on the moon—invites special treatment for well-positioned interest groups. In a word, it breeds corruption. 

Worse, the more authority the government claims for itself, the more parts of society it affects. This rouses otherwise dormant factions to defend their interests. Thus, the price of politics rises higher and higher. More federal power means more interest groups and therefore still more side deals. If you want to know why the population of metropolitan Washington has skyrocketed, in numbers and wealth, over a generation, this is the answer. An ever-more ambitious government has drawn more and more interest groups to the capital to make sure they get their cut of the federal pie.

All of this signals a profound irony of American civic history. A careful reading of the Founders, especially Madison, suggests that they were deeply concerned about the danger of corruption, a cancer they feared could rot the body politic from within. Their system carefully balanced structures and powers to prevent that. Subsequent leaders had less regard for balance and blithely expanded government’s powers without revisiting the structure. The result? A government so riddled with corruption that its people no longer trust it—and are right to doubt it at every turn.

For generations, Americans have prided ourselves on our Constitution, though we choose neither to follow it dutifully nor to revise it thoughtfully. Obamacare is the bitter fruit of our civic recklessness. It rewards or punishes factions in society according to their political prominence. Republicans may eventually manage to repeal it, but as long as the country retains a disjointed view of what our government can do, we are bound to repeat its mistakes time and again.

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