The following quote is so good ( it consititutes one of the all time major insights) that it definitely should be included somewhere in the medical student's reading list. It is the opening sentence of Chapter five, in Thomas Sowell's classic "Knowledge and Decisions" (Basic Books ,Inc.1980)
" The government as a decision maker is often regarded as simply the institutional personification of "society". But the diversities,conflicts and disparate incentives and constraints which make "society "a meaningless abstraction as a decision making unit also make government a fragmentary aggregation of decision makers." This is why "throwing the rascals out" won't work.(the replacments will likely become rascals as well as they face the same incentives and constraints). This is one of those insights with great explanatory power.
This statement came to mind, when I posted the comments about Medicare paying for glaucoma screening and the USPSTF concluding there was not evidence enough to recommend for or against screening.