The difference is that bureaucrats make decisions on behalf of others so incentives are less aligned or not aligned at all. If you drive a car and the GPS tell

The difference is that bureaucrats make decisions on behalf of others so incentives are less aligned or not aligned at all. If you drive a car and the GPS tells you to drive of the cliff, you wont do it because you don't want to die. If some bureaucrat rejects somebody's health care claim leading to them dying prematurely, it's just a normal Tuesday.