And replace it with what? Government has overhead and inefficiencies too.

I know decades of conservative rhetoric say otherwise but governments often run things efficiently and effectively.

Maybe other governments. Medicare has billions in fraud each year. The process for signing up for Medicare and Medicaid can be complicated. If you've ever served in the military or government you know how much waste can be involved.

American exceptionalism is fascinating in that it includes the belief that the American government is uniquely incompetent among developed countries.