Medicare is the most efficiently run insurance program in the country.  Check the numbers before you respond.  Claims get paid and the overhead is low - if actual insurance companies could duplicate the efficiency of Medicare we wouldn't have the mess in our health care that we do.  There are many things the government does better than the private sector - and large scale systems like the FAA and Medicare are just two of them.  I worked in some of the best private sector companies on the planet (all high tech).  I also worked for a US Government run laboratory - and I can readily say that the Government laboratory had fewer slackers, less overhead, and better performance over all than any private research I saw while working for private corporations.