Luckily, I avoided having any personal Tricare or VA horror stories thus far, most of my friends do though, I've never really done an in-depth check on how effective either are, but I doubt either is a model of efficient care per dollar, mind if I ask which branch by the way?



Well, my personal feeling, and that of most of the people in my faction of the GOP, which is one of the ones that emerged on top in the most recent series of internal ideological bloodbaths, is that privatization or delegation to the states or local should be done for anything that appears not to actually generate a net negative... of course to do that, one has to ensure people distrust the federal government more than they do the states or private sector, so the climate is rather ripe for such ideas. Some things though, we can't voucher or refund people on, at least not all the way, military, police, etc... others are big question marks, like libraries... not an ideal example since those are likely to go the way of the Dodo in the next few decades, because items like those have secondary benefits. Letting people have vouchers to pick the school option of their choice is pretty much a sure-win for all involved but letting people opt out because they don't have kids or would rather keep the money and let people be uneducated isn't acceptable, ditto infrastructure and a lot of other things but on those one could probably let states or local "opt out" and by and large we do, either they already have control or they get block grants and we just need to eliminate some of the more irritating mandates. But all of this basically stretches from the problem that most people view the gov't as a gigantic black box that takes input and produces output and does so in a mysterious fashion... and many people genuinely prefer that so you're kind of obliged to let them have it. Part of freedom is letting someone decide they want to just pay everything into the kitty, go to work at the place assigned them, and receive comfortable home, food, medical care, internet, etc along with some spending cash and I don't actually begrudge them that I just don't want them to be able to force me or others to do the same, either outright or by making me subsidize them... the free market and democracy is big enough to encompass voluntary totalitarian dictatorships. More accurately, a lot of us have stuff we'd rather just have taken care of at a slightly higher price in exchange for not thinking or worrying about it, and each person has a different set and that set varies with time too, we're all ostriches on something.



The dilemma such systems face is that most people on seeing the details will look at it, and if it appears not to benefit them, choose to opt out if they can, and then a lot of the people it did benefit will no longer want to be in for the same reason and it falls apart.