The whole "anonymous bureaucrat" shtick doesn't land anymore. The purpose of having long-term non-political staff is so that operations don't change on a whim when some rogue director comes in and wants a second Ferrari. The reason government spends more AND is paradoxically more efficient is because most of the work of those bureaucrats is tracking, reporting, and reconciliation. That's the whole deal. Congress passes laws and in those laws is usually an obscene and near impossible amount of auditing.

I trust government staff far more than the decision of unregulated, greedy corporations who literally exist to extract the most money from whatever process they're trying to sell you.

> Do you have enough information about decisions?

Me personally, No.

I don’t have enough information to make informed decisions here and you don’t either. Off the top of your head, how well educated is your dentist? You after all made an informed decision picking them. So how well did their background compare to others in your area. What where your concerns about their dental programs weaknesses and how was that offset by… Except no let me guess that never entered your mind did it.

> I'm sorry but I refuse to believe some unelected, anonymous bureaucrat has my best interests in mind or can even know me anything about me such that I want to allow them to make health decisions for me.

I'm sorry to tell you that this is, but unelected bureaucrats are constantly making health decisions on your behalf. You may not want government bureaucrats, but bureaucrats already work in your employer's HR department, deciding on which insurer to partner with, and with what benefits. They are at your insurance company, doctors office, and hospital administration, negotiating and deciding which procedures and drugs are available to you without ever asking for your opinion. Bureaucrats you didn't vote for infest drug company's research and finance offices, determining the availability and cost of your present and future care. None of these even pretend to act in your interests.

I'd rather have some government bureaucrat preside over all the other predatory bureaucrats. I sure as hell wouldn't be make well-informed decisions in the ER, or after getting a cancer diagnosis. Further, it is impossible to compare provider quality and final costs for elective, cosmetic procedures when I'm under no time pressure or stress.

> Because if something sucks, someone comes up with something better and sells it for a profit.

This is basically a religious belief at this point. It's how a perfectly ideal free market might work, but we don't have any of these, especially in healthcare.

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Markets can remain irrational, or colluding, far longer than you can stay solvent (or even alive).

For example, while the Phoebus cartel only really lasted from 1925 through to 1939, 1000hr incandescent light bulbs remain the standard offering till present day. Profitable market manipulations are sticky.

The whole notion that markets are efficient is just a mathematical construct that has become very dogmatic for people. But if you look into the details, markets are efficient under the assumptions of perfect information and infinite time. Neither of those conditions are present in the real world: we neither have perfect information nor infinite time.

> Competition. It's the only force keeping humans honest.

Pure misanthropic fantasy pretending to be sophisticated economics.

> Collusion and cartels never work on the long run.

Define "long run" - they have been already proven to have worked for years and in some cases even decades.

All empirical evidence shows that single payer systems work better, producing far better outcomes at lower cost, than the US system. In fact, so much better that a single payer system is what Congress has chosen for itself!

But seems some prefer to believe a theoretical argument with no evidence to back it up.

“The Party told you to reject the evidence of your eyes and ears. It was their final, most essential command.”