I probably have a different perspective on this than a lot of the Americans having lived my whole life in the UK until a couple of years ago when I moved out to

I probably have a different perspective on this than a lot of the Americans having lived my whole life in the UK until a couple of years ago when I moved out to San Francisco. I think my issue with this essay, and a lot of the politics I hear in America, is that two separate issues are conflated. Those issues are whether government should regulate an industry/practice/area of life (regulation) vs. if government should provide services in that industry/practice/area of life (services). There are many places where the government in the US provides both these roles, for example the financial space. For example, the Fed provides a government run service in the finance space which to provides services which are both used by private enterprise but also competes with them. In the same space the government also provide regulations and guidelines which (supposedly) protect the public interest to temper the raw self-interest of the market. When people talk about government inefficiency they generally mean that government is doing a poor job of running their services. However there also many examples of extremely popular government services, such as Medicare. The question in my mind is less about discouraging government from being in a space, but what the balance of government regulation vs. services is. A good example of this is health care. As the US moves towards providing universal healthcare there are a couple of different models can be looked at from various countries. From the UK we have a huge government run service, the NHS, which provides our healthcare. In Germany they have a strong regulatory solution in which the government mandates the criteria in which private healthy insurance companies must operate, as well as mandating insurance. I don't think many people would argue against the need for some centralised government (either at the state or federal level) that protects the commons, and the rights of man. What I would like to see more of is arguments about how we implements those rights. A good example of a debate we should have is this part of the healthcare one. The highly distributed healthcare in the US (for those with insurance) means that electronic mostly medical records don't exist or aren't shared amongst providers. In a centralised government run bureaucracy (or a private bureaucracy like Kaiser) electronic records are much more possible. Kaiser in-fact, demonstrated massive efficiency gains through their electronic records system. It doesn't mean that electronic medical records couldn't be provided through a regulatory mandate, but in order to have that discussion we have to get past the "big government" vs. "little government" and decide what we want our government to do for us and if it should do that by services or by regulation.