Well, at least the bureaucratic inefficiencies are entirely incidental to the problem, and there's no decisive evidence for corporate bureaucracies to be any better than public ones (I suspect partisanship gets in the way of finding out said evidence, as well as a slew of other variables), so that factor... doesn't factor. As for the higher taxes... how much are you ready to pay so that, the day you catch some horrible disease, the public entity will be able to afford diverting enough of its resources to save you? What are you more afraid of, cancer and other potentially-fatal diseases that will eventually kill you, terrorism/invading armies/criminals/people trying to kill you, boredom...? What would be your priorities in assigning which proportion of the taxes you pay goes to funding what projects? ... Actually that might be a neat reform. Budget decision by a combination of individual budget assignments by every citizen...