Government and business are simply different. Now the first issue is simply that a business knows if it is successful, it makes money. Governments don't make money they provide services which by their nature are going to benefit some more than others.
If a company decides to issue a new product, everyone has the chance to buy it or not buy it. If people don't like it and don't buy it goes away, if they like it and buy it, it stays.
Government doesn't have that sort of feedback and in general the things promised become more outcomes than the methods.
Now of course some things like efficiencies can be used in both places, but the Government may have to spend money that business never would.
Take the public that is simply on the edge of normalcy, outliers so to speak.
No business would normally create a product just for them, unless it was a niche company. You wouldn't be in business long if all your products were more expensive than your competition because you had to design it for the outliers as well as the mainstream.
But Government has to do this. In education we can't ignore children with conditions like ADD or Autism, we have to provide services for them and in general that makes it inefficient.
Similarly with health care. Of course if you tailor everybody's plan to what you or they think they need, some will buy almost no coverage at all. However those with conditions or who are older will pay a lot more. That is a business approach to the problem and if as a result the old and sick can't get the service they need, it doesn't matter if the policies they sell are profitable.
This is not the purpose of Government, everyone should have access to publicly funded services, and the medical industry is largely Government funded either directly or indirectly.
If you decide to take a business approach to Government the result will be outliers being left our, they are too expensive.
However, they are still citizens of this country and that should mean something.
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