If you're unhappy with the implementation of a specific program, like Medicare (which is, of course, more efficient than private health insurance in the US), let's talk about that.
My pick is the military--very wasteful. We could fold 90% of that budget into university and health care and live in heaven on earth.
Our current gov't system provide very little incentive for efficient use of funds.
I'm not arguing that all of these programs need to just disappear. I'm arguing a "race to the bottom" in terms of efficiency is a good thing, not a bad thing for gov'ts.
Having seen what races to the bottom do in various other industries, I shudder to think of how government works would suffer under the same pressure. Not the kind of society I'd want to aspire to live in.