Government run social welfare programs are actually pretty efficient since they have huge economies of scale [1].
[1]http://www.cbpp.org/research/romneys-charge-that-most-federa...
[1]http://www.cbpp.org/research/romneys-charge-that-most-federa...
E.g. that chart says that ~96% of Medicare spending went to beneficiaries. That sounds good, but all it means is that 96% of the dollars were paid to hospitals/doctors/medical device manufacturers/etc. It says nothing about how efficiently those people are providing their services, i.e. how efficiently those 96% of Medicare dollars are being spent. A lot of those dollars get quickly chewed up by high prices (which I'd argue are themselves caused by the market distortions that these programs foster).