The argument seems to be the problems was no competitive bidding. Negotiating a price only works if you can tell a wholesaler "your competitor offered me exactly what you have at half the price. " Which isn't a panacea either, if you'll pardon the pun, particularly with things like this; I was born in Houston, and, while it was before my time, I understand they had a saying in the hey days of the Moon race: "Just remember when you're hurtling into orbit at 30,000 mph: You're doing it on lowest bid.... " In this case though it looks like we had the opposite problem, and one that anecdotally arises with Medicare a lot: Medicare doesn't price shop much, and it doesn't negotiate much, which sometimes means it pays a lot more than market prices to keep the good will of seniors, who reliably vote in far greater numbers than any other demographic, and other times means healthcare providers either accept nominal Medicare payments and eat the loss, or try to collect the difference from patients who can't afford it.

Far be it from me to speak for Tom or anyone else, but I believe there are those who would say that IS the fundamental nature of socialized medicine. I don't think it's inherent, though it is sadly prevalent, at least over here, but I've always understood that to be the crux of the argument.

This would be the corruption and/or inefficiency detractors decry in government bureaucracy. Because it NEVER happens in CORPORATE bureaucracy, you see.