Generally I wouldn’t hold any hope that a public system could compete with a private one, but healthcare is an exception in large part because public healthcare systems are ruthless when selecting what medical procedures they will fund. They pursue value for money and as far as I understand achieve similar health outcomes. But they won’t innovate like the private sector, so we need both. If private healthcare can be restructured to better align behavior to outcomes, I think we could have the best of both worlds.