The essence of public health decision making

A couple of examples of the structural weaknesses inherent in allowing bureaucrats to make medical decisions:

Stationary ambulances: "Hospitals were last night accused of keeping thousands of seriously ill patients in ambulance 'holding patterns' outside accident and emergency units to meet a government pledge that all patients are treated within four hours of admission."

Some patients are more equal than others: "Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones."

Both examples are from the British National Health Service, but they're matched by similar situations in Canada.