You had me until you said the tax collector has an incentive to increase the effectiveness of health services. Currently the largest medical payer in the US is

You had me until you said the tax collector has an incentive to increase the effectiveness of health services. Currently the largest medical payer in the US is medicare, a government program. It is also one of the most expensive programs the government runs. The government already has this "incentive" and yet we don't seem to be getting healthier nor do people seem to eat better and exercise more. People seem to be getting more obese, not less [1]. I don't know of a single organization or program that has managed to have long-lasting reductions in obesity. Diets routinely fail because people can't maintain them, and exercise by definition is hard so again it's hard to stick to. One fundamental issue is we don't quite understand why people get fat. It's not clear how the basal "fat" set point that everyone has gets set, but it is clear that deviating substantially from that set point is very difficult and that it might shift over time. [1] https://www.stateofobesity.org/obesity-rates-trends-overview/ https://www.stateofobesity.org/obesity-rates-trends-overview...