What would he have done differently?
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Killing Obamacare and its expansion of Medicaid would have been a very big start for controlling federal expenditures. It was blocked by Paul Ryno and later by McCain.
In the pandemic we found out even more the dangers of government controlling healthcare. They immediately morphed into tyrannical monsters.
Just like the Patriot Act: Give the government some power and they will absolutely abuse it ASAP.