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Azathoth123 comments on A discussion of heroic responsibility - Less Wrong
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To the extend this incentive exists its fulfilled by degrading quality rather than improving efficiency.
Taxpayers don't like poor quality healthcare either. And degraded from what? It's not like there was ever a golden age where the average person had top quality and affordable healthcare, and then someone came along and spoiled everything. Public healthcare is like public transport: it's not supposed to be the best in-money-is-no-object terms, it is supposed to better than nothing.
And lets remind ourselves that, factually, a number of public healthcare systems deliver equal .or better results to the US system for less money.
But they have to solve a rational ignorance and a collective action problem to do something about it.
And lets remind ourselves, again, that, factually, a number of public healthcare systems deliver equal .or better results to the US system for less money. So it looks like they have.