In rec.food.cooking Steven P. McNicoll wrote:

It's the other way round. Free market competition keeps cost down and
service up.

Not always. One of the biggest problems with the private health care
system in the states is that the overhead for preparing insurance forms
and paperwork is staggering. I just spoke with a tech at a blood lab
in my neighborhood and she said they spend hours every day just doing
paperwork after the doors close at night. My sister who's a psychologist
in private practice also echoed the same concern to me on several occassions,
the she spends hours doing insurance paperwork, which could better be
spent treating patients.