In this way, it is the largest form of organized labor. When something is decried for 'inefficiency' we should examine what we are trying to do efficiently. For example, reducing costs of health care by negotiating drug price ceilings as a group in UK/Canada compared to much higher US drug prices as a result of rejecting these policies due to perceived inefficiency. This perception is ideological, in the mind of many Americans market equillibrium is always the most efficient pricing, this measure of efficiency is not related to the amount of healthcare delivered per dollar spent.
The "market is efficient" assumption is voided by the bastardized healthcare system in the US.
In theory the reason we have drug patents is that if you create an important drug, you get a temporary monopoly that you can use to make a lot of money, so people will have the incentive to create important drugs.
The benefit is supposed to be that the market sets the price. Until the patent expires, you pay exactly as much as the drug is worth, no less and no more.
But if the government (or even a large enough insurance company) is paying then there is no market, the buyer has pricing power. The only way the patent system produces the efficiency it's supposed to is if the patient pays for the drugs. Without that you might as well get rid of drug patents and just use tax money to fund drug research directly.
But if you talk about either getting rid of prescription drug coverage or getting rid of drug patents, politics enters and we get the inefficient catastrophe we have.
By the way, no, the goal here is not to spend the money as efficiently as possible. The primary goal is to succeed at something that is known to improve society as a whole and, perhaps, will allow that society to produce goods better and more effectively. The secondary goal is to do so as efficiently as possible. This is why you don't find much support in countries with nationalized healthcare for abolishing nationalized healthcare; instead, the support is for reforming it or making it more efficient or less corrupt or what have you. The primary goal met, it's on to the secondary goal. Before government was used as a vehicle for achieving many of these things, they simply weren't an option for most.
Government is where we come together as a people and say "yes, this is the cost that we have decided is worth paying in order to have the society that we want". That encompasses both sides---taxes ("what is worth paying") and policy ("how we achieve the society that we want"). Let's grant that there might be less competition and less efficiency (arguable), but there is greater universality, and I would say there are goals where that universality is far more important than the tradeoffs.