Can the Government Run Health Care?

One of my conservative (in today's definitions) followers asked the question of whether the government can run anything well?

I think the proper question is what does it take for the government to run something well?

Amtrak is not well run in terms of the bottom line, but they are not free to choose what lines they run because of politicians.  The Northeast Corridor runs well and is profitable.  So the issue is not Government ownership, but political interference in the demands placed upon Amtrak.

FEMA was not well run under the Bush Administration because they put a leader in there whose mandate was to reduce the costs and hopefully dismantle FEMA.  Then along comes Katrina, and FEMA fails.  Now FEMA has a leader who believes in its mission and FEMA is getting praise from the Tornado victims.

The TVA, NIH, and the CDC are all run by the government and generally well run.  Even Air Traffic Control, despite the sleeping controller problem, keeps air traffic the safest form of transport.

The military is generally thought the best run part of the government, but even there waste has been well documented; and there is the Army Term "FUBAR".   But no one is thinking about dismantling the Army because it is inefficient sometimes.  No one is thinking about defunding the military because a majority believe it is necessary.  A majority of this country believe in Medicare and would believe in Medicare for all it they thought it cost efficient.

Governments are run by people.  People do not always do things well.  This is as true in the private sector as it is in the government.  Witness the housing bubble and many corporate bankruptcies in all economic conditions.  People make mistakes.

The issue is not who runs health care.  I have yet to see any critical mass support every health decision being run by a government or insurance bureaucrat.  So health care will be run by the consumers and the providers.  The issue is the cost of these services.  Health care expense is far too complicated for me to have a detailed understanding of it.   The Health Care Reform Bill of 2010 has many concepts for controlling costs that should be successful, if Congress does not overturn them.  (I am relying on my Public Health Dr sister-in-law and the Congressional Budget Office for that statement.)  However, the VA Hospitals are generally cited as a model of efficient health care delivery.  So there is an example that the government can run health care.

Government's do things well when departments are funded and have good leadership that promote a cost efficient delivery of the services being rendered.  Conservatives could add productively to the debate by separating the issue of whether a service should be provided from demanding efficient delivery of the services.  Once a service is legislated it needs to be well run.  If a party loses the vote on the issue of providing the service, they should move on and demand that the service be delivered in the most cost effective manner.

I'm sorry that I am having trouble finding a more succinct manner to express these thoughts.