> "subscribe to a service that would independently validate pharmacies" (meaning everything on the shelf at the pharmacy), validating schools, etc all comes down to recreating work that the govt does
That's kind of the point. If the government is doing a crappy job and you can get your money back, go take it to someone else who can do a better job. Maybe even your state or local government instead of the feds.
> and then making sure that it's more cost-effective to provide good value than it is to be deceptive about providing good value.
This is the exact problem we already have with the government. It isn't inefficient because nobody wants it that way, it's because of regulatory capture and corruption. The only way out of that is for the real party in interest (i.e. the citizens) to be paying attention.
But that doesn't work at the scale of the federal government, because a billion dollars in graft is a rounding error but it's still a billion dollars, so you get a billion dollars of incentive for corruption and the taxpayers only care about that specific thing as much as they care about 0.03% of their tax dollars. But the same is true for every other individual program, so corruption and waste is rampant.
The problem is that we keep comparing the US government to the governments of other countries when it's the individual US states that are at the scale of most other countries. The national healthcare systems in Europe aren't administered by the EU. They don't have a single military or school system. If they did they would have all the problems we have by trying to do it here -- that much centralization is too big a target for corruption and too easy to hide inefficiency in the complexity and scale. There is a point at which more scale no longer yields more efficiency and instead yields bureaucracy and inefficiency.