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No need to speculate. We have 50 experiments in democracy in the 50 states of the union. Over the past 10 years these states faced the stress test of the Great Recession and the performance of state governments is measurable. As a nation, we collect an enormous amount of data. If one looks at the data using standard statistical tools, it is clear that liberal states perform better in almost every category of governance. Here are the conclusions that I have reached in examining the period from 2008 to 2016:Fiscal Governance – The crown jewel of conservative governance is the promise of responsible fiscal management, characterized by balanced budgets, low taxes, and low debt. In practice, all states but one are legally bound to balance their budgets. Upon examination, we find that conservative states do, in fact, lower taxes, but end up using other sources of revenue including a larger share from the federal government to make up the difference. There is negligible difference in the total money spent per capita across the political spectrum. Likewise, while conservative states have lower long term debt, there is only a slight difference in the balance sheet comparing assets vs. liabilities. As a result, there is little difference in credit ratings across the political spectrum with strong confidence demonstrated in the bond market. Overall, our states, both liberal and conservative are fiscally sound.Health of State Economies – The Great Recession caused economic trauma across the political spectrum, inflicting pain that went well beyond the housing market. While we are still recovering in some sectors, the overall health of the economy as measured by per capita productivity (Gross Domestic Product and Personal Consumption Expenditures) is markedly lower in conservative states and recovering more slowly. An important issue is raised, however, in asking the question of whether the economic benefits of the recovery are shared by the working class and here we find little partisan difference at the state level.Jobs and Unemployment – Where are the promised jobs? Perhaps the greatest tragedy of the Great Recession was the damage done to the workforce and the minimal effort demonstrated by conservative governments to ease the pain. Unemployment compensation programs in conservative states lagged seriously behind in both participation and compensation paid. The result was a discouraged workforce and a significant loss of workers. We have a smaller workforce now than we did at the beginning of the Great Recession despite overall population growth. Further, the jobs that are available are either not full time jobs or pay considerably less in conservative states. This is nowhere more evident than in the statistics of median salaries for men which have stagnated since 1973. Overall, conservative governance has not delivered the promised quality jobs and median household income, as a measure of prosperity, has seen little improvement in conservative states.The economy is like a very complex machine. If maintained and cared for, it will continue to produce, but if neglected it will fail. The remaining conclusions deal with how well state and local governments care for the most important parts of that very complex machine that is our economy. Specifically, how does government care for the people who make everything work?Education – Investment in K-12 and higher public education consumes a major part of state and local government budgets, but both suffered serious cuts during the Great Recession despite an increase in student enrollment. State budgets and employment figures for education show that conservative states continued to lag behind, however. Examining the results of testing at the K-12 level, students also lagged behind, especially in the critical skills of math and reading. There was overall improvement in science over the period with little partisan difference shown in 2015.The state public university system paints a slightly different picture. Serving the majority of higher education students in the United States, these institutions offer significant advantages to students who are state residents. On average, tuition and fees were nearly half that of more liberal states in 2008, and while costs were shifted to the students during the Great Recession, tuition and fees, especially in 4 year colleges, continued to be significantly lower in conservative states in 2015.Overall, state residents completing high school and college is lower in conservative states, however. The difference becomes more pronounced at higher levels. Based on results, it cannot be said that conservative states are doing a good job of preparing their residents to be productive members of the workforce.Health Care – The most significant event in health care during the Great Recession was the passage of the Affordable Care Act of 2010. This was also the most politically controversial with conservatives in strong opposition, a division that continues today. This is nowhere more evident than in the rejection of the Medicaid expansion by conservative states. Optional state supplemental health programs show a parallel lack of enthusiasm in conservative states. While conservative states employ more health workers and have more public hospitals, the percentage of the population without any form of health insurance is higher in conservative states and is growing worse. The results as measured by death rates, overall and for the most serious diseases, are higher for conservative states despite improvements across the nation. The results for children are especially alarming. Insurance coverage for children is lower and getting worse in conservative states and child access to medical and dental care is correspondingly low. As a result, the two primary measures of infant health, mortality rate and low birth weight, are worse for conservative states. Even more alarming, the long term impact of childhood health is apparent in substantially reduced life expectancy in conservative states.Setting aside the political argument of whether health care is a right or a privilege, from a purely economic point of view poor health is paid for in one way or another. It is hard to imagine that poor health in conservative states is not a factor in the productivity of the workforce.Highways and Public Roads – Constituting a little over 5% of state and local budgets, highways and public roads are the most visible of our public infrastructure. Low salaries allow conservative states to employ slightly more workers, but the results are not encouraging. Highway fatalities are significantly higher in conservative states indicating an unresolved problem in public safety.Law Enforcement and Crime – Nearly 13% of state and local public employees are engaged in the three aspects of law enforcement: police, judicial, and corrections. Like most state and local activities, these three also suffered budget cuts as a result of the Great Recession and staffing was reduced. Corrections is the only category that seemed immune to the cuts and continued to employ more workers in conservative states. The emphasis on “law and order” in arrests, convictions and incarceration in conservative states does not seem to be paying off, however. While overall crime rates declined across the country, nearly every category of crime tracked by the FBI continued to be higher in conservative states. This suggests that there is something wrong in how we are addressing law enforcement and public unrest seems to reinforce that. There has to be a reason that crime rates are higher in conservative states.Emergency Response – Fire departments including emergency medical response are a small, but vital part of state and local governments. Like law enforcement, they also suffered budgetary cuts as a result of the Great Recession, but these cuts were more severe. Fortunately, there is a strong tradition of volunteer participation in providing this essential service. Overall, the results are not encouraging. Despite improved technology, fire related death rates are higher in conservative states with little improvement shown over the period. Likewise, emergency medical response has not been able to reduce deaths due to injury in any significant way, especially in conservative states. This raises the question of why there would be a partisan difference in the effectiveness of fire departments.Safety Nets – If the quality of our civilization is measured in how well we care for those less fortunate, we are falling short, especially in conservative states and especially in the trauma produced by the Great Recession. The great hope of welfare reform legislation in 1996 essentially failed in the objective of moving people on welfare into productive jobs. There were no jobs for them to move into. As a result, families were left without assistance at a time when they needed it most. Conservative states did little to help with only one third or less of the outlay of more liberal states. In terms of basic assistance, the figures are even worse with no state-level augmentation of programs at all in many conservative states.In the case of the disabled, the picture is even bleaker with almost total reliance on federal programs, primarily under the financially troubled SSI and SSD programs administered under the Social Security Administration. State efforts have been small, both in budget and staffing, especially in conservative states. In the final analysis, there does not appear to be much compassionate conservatism at work in the country and especially not in conservative states. Have conservative austerity policies relating to welfare reduced poverty? Sadly, the answer is no and poverty has gotten worse, especially in conservative states.Retirement Security – The most serious fiscal problem facing us over the next couple of decades is the financial security of our retired seniors. Not only is there an increase in the number of seniors due to the retirement of the baby boomers, but they are living longer, their living expenses (especially medical) are increasing, there is a smaller percentage of workers to help support them, and their financial security is abysmal. After decades of encouraging people to buy their own home as an investment that they can be assured will be there if they need it, the Great Recession has taken that last reserve from many and left them with just Social Security. While retirement security is more of a national problem than a state problem, conservative states are doing less to alleviate the problem, especially in less favorable mortgage exclusion laws. Lower incomes before retirement and lower accumulated equity in homes also contributes to the problem in conservative states.The Bottom Line -- It is difficult to avoid a conclusion based on measurable data that conservative governance as practiced in America suffers from a fundamental flaw. In nearly every metric examined, conservative governments have not performed as well as more liberal governments. Even in issues of fiscal governance, conservative governments have emphasized low taxes and low debt, but have not produced healthy economies, either before the Great Recession or in the recovery. For issues of social services, budgets have been cut most severely in conservative states, but this has not produced the desired economic benefit. On the contrary, liberal states have produced economies that are more vigorous and have demonstrated higher productivity.If conservative claims that the private sector meets the needs of the citizenry in the absence of government programs, their argument is brought into question by the measures of results that are detailed in this report. Clearly, the private sector has not picked up the slack in conservative states for the metrics of jobs, education, health care, transportation, law enforcement, emergency response, poverty and retirement security. In the final analysis, conservative governments at the state level have failed to give their constituents jobs, security, and healthy, productive lives.——Thanks and a tip of the hat to Jeffrey Bradford for the edit.

As anyone who has read my other answers knows, I am not a fan of Dave Ramsey, although some of his advice for getting out of debt is just fine. Dave Ramsey became wealthy not by following his own advice (although I am sure he does), but by becoming a successful media personality. He has a radio program currently heard on some 585 stations, oft-republished books such as “Total Money Makeover,” and a financial education program, “Financial Peace University.” People pay $99-$129 for the eight-week program, which is presented in many churches and which is coordinated by volunteers. All the proceeds for the “tuition” go to Dave Ramsey’s company. He says that 6 million people have attended the program.There will be those who’ll read this answer and my credential as someone who has been in the mortgage banking industry for nearly three decades and dismiss my comments as self-serving, since I earn my living helping people incur large amounts of debt. Many of Dave Ramsey’s fans (and they are legion) hang on his every word and accept the bulk, if not all of what he says uncritically. This includes his frequently repeated claim that “responsible use of a credit card does not exist,” and that millionaires became wealthy by purchasing used cars instead of new ones.Dave Ramsey is adamantly against almost all debt, the notable exception being a mortgage under very specific conditions: the house payment should be no more than 25% of one’s take-home pay, and it should have a term of no more than 15 years “so [he] won’t be mad at you.” In higher-priced areas, this would mean saving up a very large sum of money for a down payment, thus putting home ownership out of reach of many people for a very long time, as housing prices continue to go up.Paying off one’s mortgage is simply a matter of math. A $200,000 mortgage with a 15-year term and a 3.5% rate will have a monthly payment of $1,430. To shorten the term to ten years, increase the monthly payment to $1,978. It is literally as simple as that. There are no “tricks” or “hacks” to paying off a mortgage ahead of schedule.For most people, housing is a large part of their budget, whether they rent their home or own it. Dave Ramsey goes on at great length about the feeling of “finally owning your home,” no longer being “enslaved” to the lender.But when you buy a home, whether for cash or with a mortgage, you own it 100% at the moment you close escrow. The lender has only a security interest in the property, no portion of the “bundle of rights” that defines ownership. A borrower is in no way a “slave” to the lender, just as they are not a “slave” to the utility company or the county to whom they pay taxes. They are paying for services. And when a homeowner has a mortgage on their home, they are paying for the use of someone else’s money. They receive a benefit for the interest they pay, not enslavement.Paying off a mortgage will reduce a homeowner’s cost of housing. That can certainly provide a feeling of security. But it is far more an emotional benefit than a financial one.There is a principle in finance called “opportunity cost.” This refers to the fact that putting money into one investment—a home in this case—involves giving up the presumed return they could have earned in some other investment vehicle. Ramsey claims a 12% rate of return from investing in a “quality mutual fund” (actually, one of his “endorsed local providers” from whom he presumably receives referral fees), so in that case, putting more money into one’s home would mean giving up the 12% return. That is the opportunity cost.The equity in your home is essentially non-liquid. The only way to access it is to refinance or to sell it. Although having significant liquid reserves is important (and this is one area where I agree with Ramsey), Having so much of one’s net worth locked up in a home may not be the best use of this asset.There is no cheaper money available than mortgage money. For most people, rates in the low 3% range for 15-year mortgages are commonplace. This means that investing additional money by paying off a loan at, say, 3.5% means choosing not to invest it at a higher rate. And while I personally believe that a consistent 12% return is overly optimistic, anyone can reasonably expect safe rates of return far higher than the cost of a mortgage.This is the primary mechanism by which banks make money: they borrow money from depositors at a very low rate—2% is a good rate for a CD nowadays. They lend that money to their customers at a much higher rate, such as for home equity lines of credit, with rates above 5%. This is called the “arbitrage spread.”A homeowner can do essentially the same thing as a bank. They can borrow money at a very low rate—a mortgage—and invest it at a higher rate. Paying off a mortgage at an accelerated rate means investing money and receiving a rate equal to that of the mortgage. Paying off debt is indeed an investment. Investing the minimum amount in the mortgage and putting more discretionary money into an investment with a higher yield than the rate of the mortgage will build wealth faster than paying off one’s mortgage. The difference is that part of that wealth will be in the form of an interest-bearing account apart from the real estate. If you have a mortgage with a $200,000 balance, but have an account that has grown to $200,000, you have the same effect as a free-and-clear house. You could liquidate the money in the account if you decided that you wanted to retire your mortgage ahead of schedule.For most people, paying off a home is not their most effective financial strategy. Living on the metaphorical “rice and beans”—in other words, living a monkish life of self-deprivation to pay off one’s home—is not, in this writer’s opinion, the best way to live. Borrowing money for a worthwhile purpose (such as home ownership) is not slavery. Making prudent use of very inexpensive money is a smoother path to wealth than striving to have no debt at all.I hope this is helpful.

That’s how it used to be done, and there was very good reason why the functions are now distinct and separate. I can’t think of a single efficiency that would be gained by going backwards.This isn’t me being a precious VA employee who wants to protect my old stomping grounds. This is me being a bureaucrat who’s seen the innards of the two largest bureaucracies in government - VA and DoD - and is telling you, in as direct a way as possible, why you do not want to combine those sausages.Let’s start from the beginning. Like, the beginning-beginning.Veterans’ compensation in the United States literally goes back to the Pilgrims. The Plymouth Colony determined in 1636 that those who were disabled in their fight with the Pequot Indians should receive regular compensation for their service.Flash forward 150 years, and Revolutionary War veteran Daniel Shays, angry that he was still owed compensation for his service (as were basically all veterans), took up arms against the Massachusetts government in a rebellion that literally shaped the nation as we know it today[1].The first Congress under the Constitution established a pension for veterans as one of its first acts, and so began the bureaucratic nightmare.The pension program (and its growth with various amendments) was run by the War Department until 1849, when it grew too large and was moved into the newly formed Department of the Interior.Any health care for veterans, meanwhile, remained principally a state responsibility until the end of the Civil War, when the influx of disabled veterans was too great for the patchwork of Soldiers’ Homes (some of which were Federal) to manage. In 1865, as the Civil War was coming to a close, the government formally established a network of facilities to provide long-term care for severely disabled veterans.Over time, Congress expanded the eligibility criteria for admission into these homes; and in so doing, they gradually transformed to being able to provide hospital level care.America’s entry into WWI had, perhaps, the longest repercussions for veterans’ care and benefits.The number of disabled veterans overwhelmed both military hospitals (where many were undergoing long-term recovery) and the Soldiers’ Homes network. In 1919, broad responsibility for veterans’ health care spun off to the Public Health Service and contracted private hospitals; and in 1921, Congress authorized the construction of hospitals specifically for veterans’ care.Also in 1921, Congress attempted to consolidate the various veterans’ programs under a single umbrella (the Veterans’ Bureau), but their efforts were incomplete. While the Veterans’ Bureau took on responsibility for insurance, outpatient care, and education benefits, the Bureau of Pensions (Department of Interior) still had responsibility for, um, pensions, and the National Homes for Disabled Volunteer Soldiers remained a separate entity.In 1930, Congress tried again, and so created the Veterans’ Administration to consolidate the Veterans’ Bureau, the Bureau of Pensions, and the National Homes.For the first time, the Federal government assumed, under a single organization, total health and compensation responsibility for veterans and their dependents.Between the influx of WWI veterans and the retirement of Spanish-American War veterans, spending on veterans’ services shot up through the 1920s. Moreover, Congress continued to expand eligibility requirements and levels of compensation. This led to a fateful decision in 1924 to authorize bonus payments to WWI veterans, payable beginning in 1944.When the Great Depression hit, many veterans found themselves out of work with the rest of the population. In the spirit of Daniel Shays almost 150 years before - but much, much less violently - veterans marched on Washington to demand that their compensation be cashed out so that they could support their families.Congress said, “No,” and the Hoover Administration responded by sending in the military to disperse the encamped veterans and their families at bayonet point[2].So that was a great episode in American history (and in 1936, Congress relented and authorized early payment).But the trauma of the Bonus Army and the general experience of WWI veterans during the Great Depression spurred Congress to make significant reforms to veterans’ compensation and care leading up to and during WWII. This included wide expansion of education benefits, home loan assistance, and unemployment compensation.However, as with WWI, the rapid demobilization at the end of WWII caught VA under-prepared. By the end of 1947, it had doubled its staff to operate 126 hospitals and 721 offices to manage care and process claims. The Korean War further expanded VA’s operational capacity.To get ahead of the problems encountered with rapid demobilization of forces abroad (and, if you’re wondering, I’m now starting to get to the crux of the question), VA in 1967 sent field officers to Vietnam to educate soon-to-separate servicemembers on their entitlements as veterans. This was the forerunner what’s now codified as the Transition Assistance Program (TAP).What was then a loose affiliation between the Department of Defense and Veterans’ Administration is now a statutory, funded program that includes DoD, VA, the Departments of Labor and Homeland Security, and the Small Business Administration. Attending the program - which not only covers veterans’ benefits but includes financial literacy and general career advice - is mandatory for separating servicemembers.The VA’s on-the-ground assistance to returning Vietnam veterans made it clear that many of them would need long-term assistance readjusting to civilian life. This spawned the establishment of the Readjustment Counseling Service (ie, the Vet Center program) to provide ongoing services to combat veterans who may be having difficulty making the transition back to civilian life - and, uniquely, the services are run by counselors who themselves are combat veterans.But the influx of veterans from Vietnam put strains on a system that hadn’t seen significant investment in physical infrastructure since the end of WWII. VA’s medical budget tripled between 1967 and 1977, and its rehabilitation and education spending increased ten-fold.In 1977, the Veterans’ Administration commissioned the creation of an electronic health record that could be used across its hospitals, as veterans’ paper-based records were too prone to being lost or inadvertently destroyed[3][4]. This was America’s first electronic health record, and for a long time the only one of its scale anywhere in the world. It was designed to have a core architecture that could be modded by individual hospitals to meet their own needs.It was so successful - and free to the public, having been created by the US government - that in 1988 the Department of Defense awarded a $1 billion contract (~$2.1 billion today) to copy the system for its own purposes, and make that copy totally proprietary.…Yes, you are reading that correctly. DoD paid $1 billion to take a perfectly functioning, free electronic health records system that was already US government property to make a private copy.Oh, and they managed to make it worse in the process[5].That created a decades long tech schism that defied both Congress and successive Presidents to resolve. It’s even spawned its own, little bridge bureaucracy[6].So now, with DoD and VA having failed to get along (and even failing to make use of the Bridge Bureaucracy[7]), both Departments’ records systems are being put in the hands of a single, private provider[8] (and lots of other happy tech vendors[9]).Because in no way, shape, or form will entrusting the private sector to reform the largest electronic health records systems, arguably, in the world lead to any kind of cost overruns[10] or become an attractive target for ne’er-do-wells[11].Nope.Anyway, how does all this support my position that merging DoD and VA is a bad idea to ensure continuity of care?A major takeaway from the experience of Vietnam veterans’ return to the US is, to be quite blunt, that the military gives very few shits about its people once they’re no longer connected to military operations.The Department of Defense and the services have one overarching goal: combat readiness - to train and support war fighters. Once they’re no longer in or supporting combat operations, then as far as Defense is concerned, you’re no longer their issue[12] .Going back to TAP, the law requires that DoD ensure that all servicemembers complete the course more than 90 days before they separate. This is because servicemembers often complained that, frequently, they weren’t made to take TAP courses until their very last two days in the service - the two days that their minds were very much elsewhere.However, despite both the legal requirement and the length of time afforded to separating servicemembers to complete the training, more than half of servicemembers don’t complete the training until their last 90 days, with DoD doing the baremost to monitor compliance[13] .And going back to the (ongoing) debacle of VA-DoD records inter-operability, a major issue was that VA didn’t have the political clout to go toe-to-toe with DoD on the issue.The Veterans Administration did not become the Cabinet-level, Department of Veterans’ Affairs until 1989[14] [15]. And while the previous Administrator position still required Senate confirmation, it didn’t share anywhere near the prestige (which, in Washington, equals power) as a Secretary appointment.If you were to fold the Department of Veterans’ Affairs into the Department of Defense, well, you can’t have co-Secretaries; and given that DoD has higher precedence than VA, VA would be bumped down the chain. You would be organizationally sending the message that veterans are less important than the active Armed Forces.And if there were ever a conflict between the Secretary of Defense and the now-Under Secretary of Veterans’ Affairs, the Under Secretary would basically be stuffed. They wouldn’t have direct access to the President or Congress to get their point of view across without being seen as undermining their boss.VA and DoD don’t need to be under the same umbrella to provide lifetime continuity of care. They just need to be on the same page when it comes to collecting and sharing data on servicemembers’ health history (which they mostly are[16]), at which point the VA can take over and focus on long-term care while DoD concerns itself with readiness.And if the assumption is that having everyone in the same organization will break down silos and improve the flow of data, well, that’s not grounded in the reality of the inner workings of America’s largest bureaucracies[17] [18].Of all the possible ways I could think to reform VA and DoD to improve information sharing and continuity of services, merging the two Departments would be an act of desperation at the bottom of the list.Footnotes[1] Carter Moore's answer to What was Shays' Rebellion?[2] Carter Moore's answer to How disastrous to the US would it be if all war veterans benefits got slashed to zero?[3] The 1973 Fire, National Personnel Records Center[4] A 40-year 'conspiracy' at the VA[5] AHLTA users sound off about military EHR system[6] VA Information Technology[7] EHR interoperability for VA and DoD, who’s responsible? Lawmakers, officials can't agree[8] VA picks Cerner to replace VistA; Trump says EHR will fix agency's data sharing 'once and for all'[9] Cerner reveals long list of VA EHR modernization partners[10] DoD raises budget on Leidos contract for Cerner EHR project by $1.2 billion[11] U.S. data breaches and exposed records 2018 | Statistic[12] 126,000 service members in crosshairs for separation as DoD’s ‘deploy or get out’ policy takes effect[13] Transitioning Veterans: DOD Needs to Improve Performance Reporting and Monitoring for the Transition Assistance Program[14] Reagan Would Elevate V.A. to Cabinet Level[15] Reagan signs bill creating veterans department[16] https://www.health.mil/Military-Health-Topics/Access-Cost-Quality-and-Safety/Access-to-Healthcare/DoD-VA-Sharing-Initiatives/Separation-Health-Assessment[17] https://www.realcleardefense.com/articles/2018/11/14/dod_and_the_cloud__moving_out_bureaucracy_to_focus_on_national_security_113956.html[18] After A Year Of Turmoil, New VA Secretary Says 'Waters Are Calmer'