The government cannot do things efficiently because there are Republicans in it.
No, no. Hear me out.
It is the Republican philosophical position to seek out "small government". In order to garner support for this position, they have to demonstrate that government is inefficient and corrupt. What is the best way to make the government appear inefficient and corrupt?
Be inefficient and corrupt yourself, and then become part of the government.
It is in the best interest of the Republican party's long-term policy goals to make every government agency other than the military look thoroughly bumbling and stupid.
There are dozens of examples in the wider world of government-run health services operating at a reasonable level of efficiency and solvency, so clearly the idea itself isn't intrinsically infeasible. There is something about OUR government that makes it seem implausible, and that something is a great plurality of rednecks with significantly more authority than they deserve.
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Don't really have anything to add beyond what Pang's saying (other than props), but for the curious, the above post is tackled in book form:
The Wrecking Crew by Thomas Frank (the author of "What's the Matter With Kansas?").
I enjoyed it.
Jam it back in, in the dark.