[jellicle]

If the government is the only payer, they can squeeze the excess profit out of the system year over year.

"Hey, we noticed you pay your executives $25 million a year. We decided to cut the executive pay allowance this year."

"Hey, we noticed you're paying your shareholders 50% of your revenue. You seem pretty profitable, so we're cutting your reimbursement rates for all procedures this year."

Such a system is eminently practical. What's not practical is the current US system.