Another essential role of the state is to regulate the private sector, because it won’t regulate itself.

It’s hard to argue that the state does basic, ‘blue skies’ research better than the private sector when you have companies with track records like IBM and AT&T. Then again, AT&T was a monopoly and obviously managed in such a way that the geeks could draw salaries unnoticed and do their own thing.

The state can be run with ideals other than profit; for example, Tony Blair thinks 50pc of people should have a higher education. Granted, that might be (and almost certainly is) to train the workforce and make the UK more competitive in the hi-tech sectors, but it might be because he thinks it’s a Good Thing.

Mind you, if people wanted to go to university enough, they’d surely stump up the cash? Some people simply can’t afford to. They could take out a loan, but what if they fail the course, or study something a bit useless? OK, insurance. Then the insurance company will be asking for your parents IQ scores or something to judge your premiums (a case for regulation. Should an insurance company be allowed to ask for, say, genetic tests for predisposition to disease?). The state can take a chance and spread the risk, equally. The state can ensure equality of access rights.

The long term goal of training the entire population to a higher standard is something we could all agree is a good thing, but the education of people who can’t afford it can’t be funded on a voluntary basis by those who can. So we have taxes, which are sort of semi-voluntary. You know it’s right but you hate it anyway, like tetanus shots.

I’m making a state sound a bit like a charity with involuntary contributions. Didn’t mean to come out like that.

I’d think Steve’s point is overstated, but still right. By now, we’d have got water supply and sewerage, because the relative cost is low. But at the start, it’s a commons issue – sanitation being partly a public good.

The private sector rarely, if ever, builds basic infrastructure such as this.

“The NHS shows that we can throw money at anything and it won’t get better – does the NHS have more corruption than Africa? Possibly, and that’s the trouble.”

Do you have any evidence for that assertion? The evidence of the recent past is that increased spending on the NHS doesn’t in fact vastly improve it.

The trouble with the US private system is that the distribution of spend is obscenely uneven.

And yet their stats for survivability for various diseases are better than ours, in aggregate, even across social classes. Why would this be so if the spend was so uneven, as you claim?

I am glad that I never have to negotiate with an insurance company for treatment.

Try negotiating with a quangocrat who thinks the drug treatment you need is too expensive to be provided for ‘free’.