As you mentioned, the government does often pick up the costs of catastropic coverage, commonly through Medicaid. As you mentioned, they often do a terribly inefficient job of it. Keep that thought in mind when you consider the approximately $800 billion a year spent on Medicare and Medicaid in the United States each year. That amount of money is spent to provide coverage for less than 25% of the population. It boggles the mind to hear some people claim that the same government that does such an inefficient job of health care (and damned near everything else) for such a small percentage of the population can somehow do a good job if they get control of all our health care.

My wife is the nurse manager for an outpatient pain control surgery center. She tells me constantly of the hassles of dealing with the Medicare system. Every few years, Congress passes legislation to "save Medicare." In almost every case, that involves reducing the amount Medicare pays for care, which goes a long way towards explaining why so many doctors aren't taking new Medicare patients. If you look at the cost involved of running a medical practice and the amount of time the typical Medicare patient requires, Medicare is often a money losing proposition for doctors. In my wife's center, the amount Medicare pays per procedure barely covers their costs. It's essentially a nonprofit operation. Name one other area where service providers are expected to lose money or essentially work for free.