One of the purposes of having government is to allow us, as people, to buy things (like, say, roads) in bulk, in the cheapest way that can be arranged. Another is to have a referee for private enterprise; a regulator to ensure that corporate entities acting in the nation act in the interests of the people of the nation.
Government in North America has a mixed record on both these deals, by my view.
There are, in the market, such things as natural monopolies. These are businesses, often with a goodly cost of entering the market, where the more product you make, the cheaper each unit gets, up to a limit greater than the population. Insurance is a lovely example of this; as you scale up and get a bigger and bigger pile of people-with-insurance, risks and payouts tend more firmly towards the statistically correct, and the worry that people are buying in only because they're high-risk is reduced. So, the bigger your customer base, the better the deal.
From a "let's get this as cheaply as possible" perspective, the correct way to handle insurance - all major types of it - is to nationalize it, and put absolutely everyone in the pool. Throw the cost right in with taxes, and be done with it. This is, of course, socialism, and some people object to that. Personally, I can't - because the savings on the insurance I do want are so very, very huge that it would cover the types I don't need easily.
However! Natural monopolies aren't everywhere. In cases of, for example, construction, the costs of managing and organizing a nationalized construction company are greater than the savings. Much greater, in fact. In which case, the government should stay as far away from nationalization as is humanly possible, and instead work hard to set up anti-trust, truth-in-advertising, safety, and other regulatory law, to ensure a fair and competitive market. Some markets require very little regulation to be competitive. Some require more.
Politically, both sides of the political fence tend to be morons about this relatively simple thing, and I don't know why.
On the left, there are people who want to socialize things that are plainly not natural monopolies, or worse, see regulation as a means to do things like play with rent control (which creates black markets) and otherwise try to set prices.
On the right, there are those who want to privatize or keep private industries that are pretty blatantly never going to compete properly. Or, worse, who believe that all markets are naturally, magically competitive, and only need to be set free.
This annoys me. I confess myself annoyed.
