> By the same token, most Republicans know that they will eventually get old, likely sick and finally die; thus they are not opposed to public healthcare as long as it is efficient and does not overburden public finances. However, they think (with some justification given past national federal projects) that if the US Federal government designs such a system it will be an inefficient and super costly monster pandering to special interests. And they are dead set against it.

That's a pretty laughable statement. Tons of local government (town, city, state) projects are just as much (or more) over budget with massive special interest pandering as well. The Federal government is not unique in this aspect.