While I also generally favor national discretion on social spending, the first problem is that only federal government can exercise such discretion, and conservatives have a justified distrust of how efficiently, honestly and impartially it does so. The other problem is peoples right to decide how their own money is spent, not have its expenditure dictated, especially for things they strongly and fundamentally oppose. I counter those arguments thus:

1) We have the right, responsibility and dire need of far more public oversight and accountability. It is all well to say "AUDIT THE FED111" but any such audit is pointless with no more public scrutiny than the CBO, OMB or GAO get. Complaining about how ones tax money is spent without KNOWING how is as idiotic as complaining about how one is represented without voting. Participatory democracy is ultimately a redundant phrase; unless it is participatory, it is not democracy.

2) The price of living in society is, well, living IN society. It is no more reasonable to proclaim "I alone decide how my money is spent!" than "I alone decide where my Army is deployed!" Tax money is not any one persons money: It is the nations money, hence the tax. Each of us has a voice in how that is spent, but no more than anyone else (though that is admittedly a hard sell on K Street. ) I dislike my taxes paying for US multinationals to fire my friends and family then send their jobs to Chinese non-wage-slaves, but until/unless enough people agree to elect a Congress that will end the practice it will continue.

To the latter point I would add that we tried meeting societys needs with charity alone, and most of the elderly lived in shameful bitter poverty. That all changed in 1933; thanks to Social Security and Medicare only about 10% of Americas elderly live in poverty now. Not coincidentally, US life expectancy has risen 20 years since then. The simple fact is we cannot afford to leave national needs to charity and just hope enough people will generously contribute to cover all the unavoidable expenses.

Anyway, that is the distinction as I understand it: The contention individuals both can and should decide what social needs to fund, and will do so most effectively if allowed, vs. the contention national needs must be met with national means, with no ones duty to contribute nor right to participate ignored.