That seems to sum up the resistance to robust health-care reform measures in the United States.
Such was the tired argument presented over the weekend as Senate Democrats voted to move reform from the legislative waiting room into a place where lawmakers can pursue improvements in the well being of all Americans.
A seemingly endless roster of the bill's foes complained about the page count of the Senate version, which is 2,000 pages.
Speaking Sunday, Sen. Ben Nelson, D-Neb., neatly summed up the feelings of his Republican colleagues, "I don't want a big-government, Washington-run operation that would undermine the private insurance that 200 million Americans now have."
He was echoed by Sen. John Cornyn, R-Texas, "We cannot allow Washington bureaucrats to take control of our health-care system."
"This bill creates 70 new government agencies with thousands of new bureaucrats ... with 1,597 different instances where the secretary's mandated to write rules and regulations," said Sen. Tom Coburn, R-Okla.
No matter the forum — the debate in the U.S. House of Representatives several weekends ago, tea parties or conservative talk-radio programs — fear of the large is front and center when discussing fixing U.S. health care.
A casual observer might conclude Americans have never tackled a challenge. The liberation of Europe in World War II, the construction of the Panama Canal and the creation of Social Security during the Great Depression
argue against this current timidity.
Yet, foes cite size when opposing reform initiatives sought by President Barack Obama and congressional Democrats and, for that matter, a majority of Americans in several public-opinion polls.
Government involvement would increase the size of government, a calamity in the eyes of conservatives. A more powerful federal government would get between a patient and his or her doctor. A more significant role in health care for the feds would mean rationing. It would hand your most sensitive medical information to an uncaring bureaucrat.
From these fears spring Sarah Palin's nightmare "death panel" or other fevered fantasies.
The truth is the United States is a large and populous country with a similarly hefty problem, namely a fragile system for treating the sick and keeping the well healthy.
The nation's for-profit system has the highest costs in the world but quality ranks behind much of the planet, according to the World Health Organization.
Ranked by life expectancy, the United States is well behind much of the industrialized world.
In 2004, the National Academy of Sciences' Institute of Medicine found, "Although America leads the world in spending on health care, it is the only wealthy, industrialized nation that does not ensure that all citizens have coverage."
Numerous studies by reputable outfits, such as the Institute of Medicine and Harvard Medical School, estimate tens of thousands of Americans die annually because they lack proper health-care insurance. A 2007 Census Bureau study found 45 million Americans go without.
We repeat: This is a big problem requiring a big solution.
The architecture of the current health-care system undercuts many of the conservatives' fears.
In most states, a single health-insurance provider monopolizes the market. In Alabama, for instance, Blue Cross/Blue Shield of Alabama controls 90 percent of the market.
(Not to fear. Congress gave health insurers an anti-trust exemption more than five decades ago.)
Of course, these legalized monopolies already ration health care for their clients, deciding who gets an operation, specific types of treatment and certain brands of prescription drugs, to name but three examples.
These large health insurers stand between you and your doctor.
They also stand between Americans and their senators and representatives, handing over millions in campaign cash to lawmakers who will do their bidding.
These cold facts ought to leave lawmakers ashamed.
While Republicans have turned into the party of "no" in standing astride health-care reform, too many Democrats have set their sights too low in fixing a problem that will only worsen as the years go by.
Americans put Obama in the White House with the expectation that he would tackle big problems in a big and bold way. Now, as Congress creeps toward reforming health care, it's time for a big vision from the White House.
