> You are dealing with government. Its not a business like Instagram or a grocer like Costco. If IG crashes consistently or if Costco has long lines at chekout, you take your business elsewhere.

In a democracy, when the government fails, you can vote it out and get a new one... and you get as many votes as a person with 100x your spending power. In the free market, a business that effectively serves a specific market can thrive despite absolutely abysmal performance for the rest of the market. It's not unusual for a business to be better off if they can get rid of certain customers, because they're a net cost to the business. So they have every incentive to be as hostile as possible to those "customers".

> With Medicaid you dont have an option, and the govt program, unlike IG or Costco, will never go out of business due to poor business services

It's not like the poor and indigent have a lot of influence over IG & Costco either. ;-)

You'll notice that Medicaid and Medicare have different levels of service. There's a reason for that (not a very pleasant one). There are different levels of service between Medicaid to discount private health insurance (particularly pre-ACA private health insurance), and the comparison makes Medicaid look pretty good. Go compare this case to the cases against private health insurers, and then tell me that private health insurance works out better.

>In a democracy, when the government fails, you can vote it out and get a new one.

When's balloting for HHS principal deputy administrator? I keep missing those elections. :-)

Americans have time and again voted against social welfare.

"Social welfare" hasn't been on the ballot for well over a century.

That's a fine point. If you can't vote for each individual position in the government, then really you don't have the same influence you have over a multinational conglomerate's insurance division.

If this is supposed to be some argument for how the free market actually provides accountability, I would love if you could cite the last health insurance company that died because of their poor business service.

The application process parent is talking about is Medicaid, not Medicare.

Medicare is pretty ironclad, because the recipients are elderly and vote. Medicaid recipients tend to be marginalized and high need, so they’re used as a punching bag by local governments in states where that’s a good way to score political points.

This particular system wasn't nationwide, it was a system that the state of Tennesee paid 400 million dollars to Deloitte for. Conveniently, Tennesee is one of those states filled with people who think "Government bad" and gets tons of tax dollars from states like California and New York at the end of the day.

My experience so far on Medicare (a couple years) has been that it is equivalent to the private insurance I had before. No surprises.

You don't have to move to Medicare if you do not want to - you can continue with all the private insurance your employer offers or you can afford, or you can 'self insure'.