All this is true, but I do not agree with his conclusion that "[w]e need a single-payer system." If there can be greed, dishonesty, poor allocation of resources, poor insight, and lack of foresight in big groups, why should we think that a single-payer system would be any better? Perhaps it is hope: we hope, we wish, we want to believe that there is a single-payer system out there to make all of these headaches go away. I don’t believe it, however. I think there will be just as many headaches, and probably more, under a single-payer system—headaches that are hard to imagine right now.