Marc,

If this discussion is headed for taxation is coercion and therefore all government is inherently wrong/evil/unjust/improper, etc then we can stop there.

Death and Taxes. The two givens in life. It is unstated, but those taxes are spent in a marketplace somewhere. That's just the real world. In 2007, federal and state governments spends about 50% of all that is spent in the healthcare marketplace. You might hate it, but that's the way it is.

Now, back to the original. Assuming that people hold the federal government accountable on spending and taxation (and I agree that is a problem), the government should act like any other actor in the marketplace only on a much grander scale. They will want maximum good for minimum price. Therefore, allowing the US government to ask for the same price as other governments is perfectly reasonable and in line with what I'd expect of a financially prudent administration.