I think impartial observers have not spent time in actual government bureaucracy. Basically everything will seem like “they’re cutting something important!” Or “they’re stopping critical research!” because every government contract needs justification; so naturally they will all sound good. The data and accounting itself is such bad quality in all cases that it is impossible to be perfect at this; there are entire in…
It's also absolutely true that private companies are endlessly wasteful. I've worked for four large companies now, and the waste is mind boggling. I think what upsets people about government is that tax dollars are used to fund it, but I would claim from my own observation that beyond a certain size any kind of organization is filled with waste.
I'll point out, though, that there are areas of government that have been studied and found to be very efficient, and have high levels of satisfaction. It's been quite a while now, but I recall around ~2006-2007 an academic study came out which was originally intended to look only at private insurers. As they designed the study they realized that given the size of Medicare they should also include Medicare as part of the study.
What they found:
- A much much higher percentage of the money going into Medicare goes toward patient care than in any of the private insurers. Like low single digit percentages of overhead vs. 10-25% overhead in the case of the private insurers.
- Customer satisfaction from dealing with the bureaucracy (claim processing) of Medicare was much higher than customer satisfaction with the private insurers.
- Patient satisfaction with the care they were receiving from Medicare was as high or higher than the private insurers.