I'm going to reproduce the following post by Think Progress's Matthew Ygelsias, because he's right on about the effectiveness of government per se: some agencies/departments carry out their mission better than others. One of Megan McArdle's correspondents rants against the evils of the DC Department of Motor Vehicles before snarking " I can't wait for the government to take over our healthcare system." A common enough sentiment. But look — the government already runs a fleet of air craft carriers. Worse! The government's taken over our national monetary policy — mistakes can plunge the country into recession or a destructive cycle of inflation. And as if that's not enough, they run a vast arsenal of nuclear warheads capable of destroying the entire planet. Which is just to say that if it's not conceivable that there could be a well-managed government agency, then we're all doomed irrespective of what happens with health care. But in fact if you look across the country or around the world, you see some highly effective public agencies and some highly dysfunctional ones. Obviously, you wouldn't want the health care system run like the worst of those agencies, but that's hardly to say that a highly effective government health care agency would be impossible to achieve. Simply because an entity is a governmental entity guarantees neither success nor failure. However, one advantage that governmental entities do have over private entities is that the former, by definition, are subject to the demands of citizens for better execution.