The one concern that I have with a government "gatekeeper" is in the case of those with "experimental diseases", that is, the health problems that can't be diagnosed and so the doctors work out their best guesses, or that can be diagnosed and for which ingenious new procedures may be more effective than the tried and true. I have helped two of my employees fight the company health insurer to get coverage for new treatments, including going to the state Insurance Commissioner, and even more powerfully, the press. But imagine trying to fight such a battle with the government - might as well just lay down and die, 'cause it ain't gonna happen.