The VA hospitals arn't the only government run healthcare in the world. Some others are good, some are bad. As with everything reducing the options down to two political choices just seems to makeveryone stop thinking about creative ways to solve problems.

The uber thing is a good choice for Innisfil. They wouldn't have the money to roll their own ride share, and they can't afford the infrastructure to create a bus system.

The VA hospital example is an interesting one. I was at a town hall with Lindsey Graham where he used it as an argument against universal public healthcare. And clearly, no one wants universal public healthcare to be like the VA system -- where there are a limited number of understaffed government-run hospitals, and you get no choice as to your doctors.

But the interesting thing is that absolutely no one is proposing that; what's being proposed is Medicare-for-all, where you get your choice of providers (pretty much any existing provider), and you pay the government for low-overhead insurance through your taxes.

It's kind of a really obvious rhetorical bait and switch, but it seems to resonate with people.

I'm a little more skeptical than you. I think it's interesting they are trying this, but uber being a good choice? We'll see. How many drivers sign up? Are rides available when needed? etc. Uber has shown they replace taxis pretty well, but have they shown they can replace public transit? Let's find out...

I wonder if there's some research on this somewhere.

Organizations like NASA or the entire US military apparatus are also government-run, but you never hear free-market conservatives argue that US military sucks or is inefficient.

On the other hand, there are plenty of private organizations that are universally hated, like Comcast, American Airlines, or Bank of America, which are also huge, bloated, and have tons of waste internally.

You've picked poor examples.

NASA just gave up on making rockets and arguably going private is going well for them.

US military is quite famous for inefficiency. F35, B2, the 100 million dollar gas station in Iraq etc. Given the mess in the middle east, effectiveness is questionable as well.

Arguably, NASA gave up because it was funded poorly for decades. The rockets they're using are Roscomos rockets anyway, which is another government-run organization.

US military is pretty effective in its primary function, but may not work as well when required to adjust to something like policing the population, sure. But that's a separate discussion.

But yeah, those were just a couple of examples. There are plenty others.

- University of California system, along with many other state universities.

- Various three-letter spy agencies

- Your local fire department etc..

I'd say that it doesn't matter whether any given organization is private or public. What matters is enough funding and semi-competent management.

> US military is quite famous for inefficiency. F35, B2,

Those are private industry contracts.

I kind of hate how people on the right can cut government funding and then turn around and complain that the underfunded programs are functioning poorly.

Sort of like how sometimes when government tries to solve a problem with a certain program and, if the problem gets worse, the solution suggested (and often tried) is to give even more resources to the program instead of trying a different program with different people.

Run option A in one location, and option B in another, then see which works better? Of course the key would be to replicate the results in other locations to make sure the "better" option actually pans out.

Are there any policies that were built this way?

In a sense, the US states are supposed to work this way. Supreme Court Justice Louis Brandeis described them as "[Laboratories of Democracy][0]". For example, the health care system governor Romney instituted in Massachusetts (Romneycare) was moderately successful, and was adapted to nationwide use as the ACA (Obamacare).

However, you can never really control for differences between the states, which means weak predictive value, and it's easy to argue about results. And given that the policies we're talking about are inherently political, facts and evidence don't necessarily contribute to policymaking.

[0]: https://en.wikipedia.org/wiki/Laboratories_of_democracy

I dunno, I'm pretty happy in a country where all the major universities are public and the healthcare system is socialized.

The great thing about for profit options is that you don't have to fund them at all.

A good government option shouldn't require ANY funding at all. It should pay for itself.

Why?

The government may wish to

- provide a service that pays for itself only indirectly in the long run like investing in its citizenry and their well being.

- price a service below cost to enable the citizens who most need the service to actually benefit from it

- serve the entire citizenry not just those profitable to serve

What these have in common is that they represent a transfer of value from those who have more to society as a whole. This is pretty much how every decent functional society in existence works at scale.

Virtually nothing the government does "pays for itself" because economic systems while useful are so bizarrely insufficient by themselves that I'm not sure I have words to express it. They suffer from insufficient information, outright corruption and outright failure to encode most of what is most worthwhile in dollars, cents, and incentives.

Those who believe in capitalism alone seem to be appealing to some bizarre pure state of nature that has never existed will never exist. Meanwhile ignoring the fact that everything about capitalism as practiced anywhere on Earth is a wholly artificial mashup of perverse incentives, short time thinking, rules, regulations, and customs based in part of what can be exploited, in part on what people think is right, and in part on what people think is useful.

Given that capitalism is as artificial construct as opposed to some ideal state its easy to argue that we the people ought to use our political power transfer wealth from the haves to increase the health and well being of society as a whole.

Because of this government options will often be aligned with what society as a whole can afford and will benefit from in the long run as opposed to what those directly benefiting right now can support out of pocket.

The bad thing about for profit options is that they often don't work in the best interests of the consumer. Particularly egregiously when being granted a monopoly.