I appreciate Mark’s effort to discuss Democratic failures. I disagree with many of his points, and agree with some.
1) I disagree with his dismissal of “exogenous factors” like bad campaign management, voter intimidation (and suppression), and fake news as explanations for the disaster of 2016. As someone wisely wrote in a recent letter to the NY Times, when a basketball team loses a game by, say, 96-97, there are any number of sufficient causes for the loss: a missed foul, an injury, a poor substitution, a bad referee call, etc. The same is true for the election result, especially when you add such other “exogenous factors” as FBI Director Comey’s last minute intervention and the one-sided hacking, presumably at Putin’s behest, of Democratic emails. Since Hillary won the popular vote by a large margin, virtually any of the “exogenous factors” could have won it for Trump.
I do agree that the Democrats have grave faults of their own, well worth examining as key factors in the long, otherwise inexplicable failure of the Democrats to defeat a Republican Party that has become a cheering squad for the rich, and at least since Reagan has proven corrupt, nasty, and dishonest. But many of his points are wrong.
2) Mark’s comments about the overweening size and cold-blooded nature of the government echo a consistent Republican refrain. The size is factually incorrect: from 1962 to 2014 federal civilian employees increased by a total of 8%, whereas the US population grew 65.7%. But it’s popularity has less to do with facts than with a consistently repeated claim emanating from the mostly large businesses that dislike controls on their false claims, pollution, employment discrimination, monopolization efforts, and workplace safety.
3) Likewise factually incorrect is Mark’s statement that “Government's ability to manage complex processes inevitably reaches a point of diminishing and then negative returns.” [his italics]. This sounds plausible, but there are many modes of regulation. The techniques that work in a small and simple system must change as the system does, and on the whole that’s what happens. There is no inherent reason, apart from political opposition, why regulation cannot continue to adapt as it always has. The real point of difference is that Republicans believe in the honesty, decency, and voluntary law abidingness of businesses whose priority is to make a profit in the short term, and Democrats do not.
4) Mark’s discussion about medical care is likewise inaccurate. He says “modern medicine is tortuously complex and requires decentralized decision-making and on-the-ground engagement by an array of skill disciplines. Medical service thus by its nature defies top-down regulation.” Again, Mark expresses a fairly simplistic view of regulation. If he were correct, the medical care systems that prevail in virtually every other developed nation would all be considered failures. In fact, by the available measures most of them do a better job at something less than half the US cost. Moreover, even Medicare and Medicaid in the US make adjustments for differences in medical practices and local expenses. The complexities of the US system are, rather, due to the Republican insistence on private, employer-based medical insurance in place of a simple government-financed approach. Likewise, the so-called failures of Obamacare are largely due to the opting out or refusal to extend Medicaid by many Republican governors, and the implacable opposition that Republican Congressmen have mounted to the entire program, making the normal post-legislation adjustment process impossible.
5) In one respect, though, I agree with Mark’s diagnosis. He notes that Obamacare became a short-hand for every nuisance and gripe about medical care, and that this followed from Obama’s misconception of public perceptions. I think that Obama’s failures in the realm of explanation and persuasion are the most serious faults of his administration, and this is one example.
6) I also agree with Mark’s claim, in discussing the EPA, that liberals can be at least as dogmatic and irrational in the pursuit of their goals as conservatives. I don’t know that EPA regulations actually exemplify the point, but I do believe that the point holds true in many contexts.
7 Now let us consider Mark’s belief that Democrats are losing elections because “they have abandoned their legitimate mission of being empathetic champions of humanity and have instead become tagged as the party of pitiless bureaucracy.” This claim has some credibility with me. Perhaps the party has become tagged as the sponsor of pitiless bureaucracy. I have not heard that before, and it has not come up in the various books that I have read about the supporters of Trump. But being “tagged” is certainly the type of emotionally laden, media-savvy charge that could well have taken place, and would certainly resonate. I also think Mark has a point because it echos the thought-provoking claim in Thomas Frank’s recent book Listen Liberal that Democrats have become the party of professionals and disregarded their traditional base of unions and working people.
8) Finally, there is a sense in which I sort of agree with Mark’s last point, that “by smugly belittling any serious politician to their own right, the Democrats threw away this election and cleared the field for Trump.” The sense in which I agree is that Hillary did not campaign on the issues. Perhaps she tried, but much of her time, and certainly her most attention-catching efforts, were devoted to ad hominem attacks on Trump, rather than discussions of the policies she advocates. This was utterly inexcusable as a campaign tactic, since exactly this approach had led Trump’s primary opponents to doom. Her campaign managers should have known this, and Hillary herself should have rejected any advice to proceed in this manner.
 In 1962 there were 2,514 million civilian employees of the federal government. In 2014 there were 2,726 million. See OPM.gov, Historical Federal Workforce Tables, Total Government Employment Since 1962, https://www.opm.gov/policy-data-oversight/data-analysis-documentation/federal-employment-reports/historical-tables/total-government-employment-since-1962/, During the same period, the US population grew from @185 to 308.7 million, according to the Census and the Statistical Abstract.
 They would rather play states off against each other in a pitiless race to the bottom than be subject to uniform federal regulation.
 Mark argues that the EPA does not factor cost into its regulations. I don’t believe this claim, as
the use of cost-benefit analysis is required of the EPA by executive order, and I don’t think the EPA flouts it. “President Reagan also recognized the problem of unaccountable regulatory agencies. He responded by issuing an executive order in February 1981 that required executive branch agencies, like the Department of Health and Human Services and the EPA, to perform CBAs before issuing major rules.” Conservative Reform Network, Requiring Cost-Benefit Analysis for All Regulations,” 9/27/15 at http://conservativereform.com/requiring-cost-benefit-analysis-for-all-regulations/