That’s interesting, because your latter example is pretty excellent. USPS can deliver to anyone in the country (unlike the private companies) and I’d say it’s pretty streamlined. The IRS is definitely in a bad position, but there are two problems: firstly, they’re only enforcing the tax code written by Congress. They can’t just streamline the tax code. Secondly, there are private companies lobbying to prevent the IRS from being as good as it could be. And that will obviously be the same with health care.
As a country, we’ve decided it’s in everyone’s best interest to be able to get mail. Private enterprises cannot solve global access problems because they have no incentive to go the extra mile for the last few people the system can’t reach. (Which is why internet is so shitty in rural parts of the country.)
So why not health care as well? To me, it seems like the problem are solvable.
We clearly differ on the USPS. FedEx, UPS, DHL, etc clearly provide superior service for overnight and courier service. Rural service could be solved - it simply has a cost. To your point, "as a country we've decided that it's in everyone's best interest to be able to go get mail." We have also decided to subsidize the cost of the service with metropolitan customers subsidizing the rural (similar to phone service). If the US used taxes to pay a FedEx, there would be better quality service at a lower cost.
Having the government provide the service introduces politics to the operation of running a business. Where should post offices be located, how often should mail be delivered, what products should we offer, should prices vary according to cost to delivery, etc. These issues make the USPS what it is today - a bureaucratic behemoth that is still delivering Christmas cards from 2020.
Of course the problems are solvable if you have desirable incentives. But as Pournelles Iron Law of Bureaucracy points out that the incentives to solve the problem are ALWAYS eventually replaced to preserve and grow the bureaucracy. And that’s why a universal, government solution is doomed to fail.
Funny you mention bad rural Internet considering that’s a problem technology and competition is about to solve.
As a country, we’ve decided it’s in everyone’s best interest to be able to get mail. Private enterprises cannot solve global access problems because they have no incentive to go the extra mile for the last few people the system can’t reach. (Which is why internet is so shitty in rural parts of the country.)
So why not health care as well? To me, it seems like the problem are solvable.