While I don't like your use of the word "socialist" for labeling programs like those, I completely agree with your take on the problem with effectiveness, and not getting the money's worth.
Capitalistic competition is key.
-Hedge
I don't think it's the key. It's the problem. One, Unmoderated capitalism results in monopolies. Monopolies set the price of services/products. We have a concentration of Insurance company ownership that could rightly be characterized as monopolistic.
Two, profit motive is driving the costs through the roof. It takes money to fund pro golf tour events (Lincoln, Pacific Life etc.), pay executive compensation, pay golden parachute arrangements, pay for advertising, pay for corporate jets and luxurious corp. HQ, and still show a profit to shareholders.