https://www.uspsoig.gov/blog/be-careful-what-you-assume
The U.S. Postal Service represents a compromise between a popular convenience and demand for private profits. To preserve UPS and Fedex profits, the Postal service must not be allowed to compete on a level playing field. In a similar way, Amtrak was designed to be incapable of posing a serious threat to the Airlines. Part D medicare was a bone thrown to Big Pharma and the Insurance Companies. Obamacare was emasculated by elimination of the public option and then seriously wounded when Republicans sued to allow States to opt out of medicare expansion. An entirely intact Obamacare would have posed an unacceptable threat to the AMA, AHA, Big Pharma and the Insurance industry. Something had to be done, and it was.
It's no wonder people think the government can't do anything as well as private industry. Though there are many government success stories, they are soon overshadowed by prominent, popular, but hobbled programs handicapped from the outset, or as soon as the political tide turns. If you're in a foot race, but you're the only one with both feet in a gunnysack, you'll probably lose. If a government program proves wildly successful to the point of threatening private profits -- social security, medicare -- it is easy enough to hobble it with a poison pill. For years, the most insidious way to weaken Social Security has been to ignore the Actuaries, and thus the Trustees, recommendations. Medicare has been blocked from negotiating drug prices, and now the rules are being changed to reduce coverage and throw up new hurdles. The real problem with Medicare is, of course, charges 100% higher than in any other industrialized nation. Logic would have it that you would do something to force down charges. But logic does not prevail when private profits depend on it not prevailing. So instead of bringing cost down, cost is shifted. That way illogical, out of line profits are preserved, and financial support for Congressional races is maintained.
