Anything that is public health related is bound to be full of tradeoffs and "good enoughs". The water in Flint, MI was considered good enough by Flint's officials, as is the water in many other municipalities.
Just as a private monopoly would start to reduce quality once it cornered the market, public, regulated monopolies behave similarly. Why care about quality if there is no competition and it's just another year earning a pension for the bureaucrats involved?
Consider how the bidding process for building roads results in poorly built roads and no incentive to the winner of the contract to build something that will last. Nearly every piece of American infrastructure is riddled with corruption or incompetence (or both). Even basic construction is full of various rules intended to bolster union workers, etc. and adding enormous cost.
Just as a private monopoly would start to reduce quality once it cornered the market, public, regulated monopolies behave similarly. Why care about quality if there is no competition and it's just another year earning a pension for the bureaucrats involved?
Consider how the bidding process for building roads results in poorly built roads and no incentive to the winner of the contract to build something that will last. Nearly every piece of American infrastructure is riddled with corruption or incompetence (or both). Even basic construction is full of various rules intended to bolster union workers, etc. and adding enormous cost.