A decently run government program is cheaper than private industry since there are no profit margins involved. That is how most civilized countries have medical costs per capita around half those of the USA yet still deliver better quality care to more of their population.
If you look at the best rated hospitals in the world, the USA consistently appears at the top of that list. The includes places like Saint Judes, Johns Hopkins, Hershey Medical, and tons more.
Also, the reasons for expensive medical care here in the USA is several reasons:
- Malpractice insurance can be over 50% of the cost for doctors like OBGYN
- The $100 Aspirin at the hospital is the result of cost shifting. It's to offset those who don't have insurance. Hospitals have to swallow this cost. MOST hospitals are non-profit.
- A lack of qualified medical staff (therapist/nurses) causing prices to pay to shift upwards compared to other countries.
- We in the USA are financing medicine for the rest of the world. You may find this hard to swallow, but I personally have inside experience and knowledge how EXPENSIVE it is to create a new drug that can be patented. I know at my old job, one of our main clients was pharmaceutical companies. Our equipment was NOT cheap. And I walked in labs where there were dozens or even hundreds of these specialized machines looking and testing for new drugs. Organic chemistry is a bit of a @#$#@ as a protein fold can be unpredictable and random. (Combinatoric chemsitry brute force research method) Because countries like Canada said we won't pay more than $5 for this pill. The mfg company goes "Okay we'll we need to be able to pay for all this research equipment for new drugs. So we'll shift that cost off to the USA" That said if there were no price limits in other countries, it doesn't mean our prices will come down much. It's one of those unknowns. It's also one of the reasons Universities are also so expensive. When universities buy equipment there are unique price schedules for educational institutions. Why? Because the people selling the goods/equipment know the cost will be shifted onto the kids.
Gov't contracts are by far the most inefficient of all programs because there is little to no accountability. For example the Heads up helmet for the JSF is MASSIVELY over budget. Each helmet cost a fortune with massive delays and cost overruns. That is an uncontested gov't contract. If you work for the Federal gov't you have to MASSIVELY f up to get fired. Thus there is no accountability. My best friend's ex wife took years of unacceptable performance at her gov't job as a secretary before they could get rid of her.
SpaceX created a space delivery system that is far far cheaper than anything else Lockheed/ULA/Boeing have managed to create with gov't incentives. That is why NASA opened up the process to free competition without gov't contracts. The most efficient program won funding, thus putting the onus on businesses to be efficient. The same for Virgin Galatic.
That said, I do believe in the evils of monopolies. But big business and big paychecks aren't necessarily bad provided that power is NOT abused. (IE: Facebook/Comcast/Google/Microsoft)
If you wonder how I know so much, my wife being an OT, was active in reform at the gov't level to reduce fraud and the cost of health care through legislation. I was helping her with this research. My specialty is really computer programs related to engineering. But I have degrees in astrospace and computer science. And I follow what happens at NASA carefully as I used to work there (Goddard Space Flight). This is before my work creating tools for scientific instrumentation. These days I mainly do engineering raters on thermodynamic systems.