Reducing theft is the main reason I believe. Also providing someone who can direct you to where you go when you get in the store if you have questions. On nego

Reducing theft is the main reason I believe. Also providing someone who can direct you to where you go when you get in the store if you have questions. On negotiating drug prices: That market is pre-broken due to us handing out patents in an attempt to spur innovation (It's not a bad attempt, it's probably the best tradeoff one could come up with to push advancement, it just totally breaks the market for the drug while the patent is in force). You are certainly right that size will give negotiating ability. I am not convinced the organization needs to be extremely large but it probably requires at least a few million patients. That being said I don't know what the optimal system is other than we are probably far from it because it's kind of complex. If your pricing power is large enough to move the expected value of a drug down, you are diminishing the value of the patent and decreasing the effect on new research, for example. The large system's negotiating power is also only as valuable as the skill and motivation of that system's negotiators and that skill and motivation is far from guaranteed. There are also tertiary regulatory effects limiting the competition in the generics production sector. I am not sure the relative importance of any of the points I raised or or the relative importance of the numerous other factors I didn't list and/or didn't think of so it's really hard to say for sure what the optimal solution is and in that situation I am totally fine with a public provider but I want my ability to use a private provider to be maintained and ideally the public provider should be charged for as a user fee I can opt out of so if it's garbage none of us have to use it.