re: government expertise
The axiom now is that health care is expensive because it has a private component, and that if it were all run by government, it would become cheaper.
We haven't had real competition or free market forces in medical care for years, so the current system can hardly be called a failure of the market. Private insurance is heavily regulated and prohibited from varying their policies or adjusting to real customer wants. Public insurance has carried large sectors of our medical care for four decades.
Look at this:
Since 1960, the percentage of the nation's medical bills paid directly by individuals has declined, while the share paid by the government and private insurance has grown. In 1960, individuals were paying nearly half (48.7 percent) of the nation's health care bill. By 2007, this figure is estimated to have declined to 12.0 percent and projected to decline to 9.8 by 2018. Government's spending on health care (both federal and state and local) increased over the same period from 24.5 percent (in 1960) to 47.7 percent (in 2007). By 2018, government's share of health care spending is projected to be 51.3 percent.
The original source (shown on the chart) only goes back to 1960. Be interesting to see what 1950 looked like.
Health care costs have gone up by almost the same factor as consumer payment responsibility has gone down. I've seen the hospital bill for my birth. I saw a graph in Consumer Reports on health care costs in the U.S. (I can't find it online). The chart rises evenly until the middle 1960s, then angles up. The knee in the curve is obvious. It's hard not to connect this with Johnson's government medical care actions.
When things are subsidized, the price goes up. This is not something I just made up last week. It's how things work.
The reason health care is expensive is because it's been insulated from market forces, not because of them. You really need to let that sink in.
In addition, if you nationalize the system, and impose the inevitable wage and price controls, you will end up with inferior care. Other nations can provide decent health care cheaply for exactly the same reason they can provide defense cheaply: the heavy lifting on technology, research, production, and manufacturing is being handled someplace else where people can still make money at it.
Just one example to consider: When all drug prices are held to artificially low levels, who pays for the new drugs? Approval of a new drug current costs in the hundreds of millions. Will FDA approval rules have to change? Will taxpayers cover these production and approval costs and the industry be operated at a permanent loss like so many other government industries?
You really think running a system based on politics will turn out better than a system based on profit? Does the Defense Department make the best cost-benefit decisions possible when deciding what to build, where to do research? Does NASA? Or does it matter more what's in some Senator's district or who's been pumping the most contributions?
Is the Yugo really the best car in the world?