The reason we don't have free tax preparation software (or a tax system that doesn't require that) and don't have free health care is because of competence issues. Taxes seems like a different dimension of problem, so let's leave it aside for the moment. Do we really believe that the people that work in the government here (in the US) are actually competent enough to administer a public health care system? I don't. I'd like to be convinced otherwise. Maybe you mean to say that we'd, I don't know, outlay lobbying and redirect that economic activity toward paying market salaries to people who are, in fact, competent enough to administer a public healthcare system.