[negamax]

Healthcare is expensive and have massive fines built in for good reasons. Government jobs are for life with little to no repercussions. Also they might not align people correctly with incentives. We need government run programs with private sector like efficiency.

[naasking]

> Government jobs are for life with little to no repercussions.

This is one of the main problems: without some kind of feedback mechanism, this means bureaucracy can only monotonically grow which means inefficiency can only increase. At some point that inefficiency starts making private healthcare look competitive.

[negamax]

That's pretty much it. Government jobs are lower paid because money comes from taxing private sector. Career growth there is all about how big of a team in numbers someone has reporting to them.