The points I posted are a few examples of the government doing a poor job at dealing with the public's money. With medicare they past laws preventing their ability to negotiate. For schools in the US, the federal government has no limit on the amount of loans they can give it. I think these are relevant to the government's negotiation ability as in both cases they're allowing the counter party to abuse them to the detriment of the public. I don't trust that if the government is the single payer for healthcare that they won't let the pharmaceutical companies and hospitals take advantage of them.