How can the government pretend that it can manage, overhaul, streamline and reform the health care system in the United States when it can't even deliver enough flu shots to prevent a pandemic?

We have seen the H1N1 virus coming for over a year. It is no surprise that much of America needs vaccination. It was no secret that the flu season was approaching. But, now that it is upon us, we find ourselves pathetically short of shots.

One year ago, the government told us that we would have hundreds of millions of vaccinations available. Then, over the summer, the prediction was that 40 million would be on hand by the end of October.

Last month, the estimate was scaled back to 28 million. And, as of late last week, only 11.5 million had been delivered, leaving tens of millions vulnerable and, tragically, likely leading to hundreds of preventable deaths. Given the tendency of the virus to strike the young, many of those deaths will be among children.

It should be a fairly simple task to produce and distribute a vaccine -- as we do with regular flu shots each and every year. But it was apparently beyond the capacity of the Obama administration to manage such a routine feat.

If it can't run the epidemiological equivalent of a two-car funeral, how can Obama promise that the government will do an adequate job of managing the nation's health care system? (To say nothing of two car companies and a trove of banks and insurance firms?)

In the debate over health care, the implicit assumption has been that the government can act with competence and timeliness. The discussion has largely centered on what powers to give the government -- not on whether it had the ability to wield this new authority.

The bill making its way through Congress empowers the federal government to decide on protocols of health care, penalize excessive costs and moderate reimbursement fees. These are all difficult and delicate tasks, and involve decision that must be made promptly and wisely for the system to have a chance of working. Otherwise, endless delays, bottlenecks and snafus can eventuate. And these failures can have drastic consequences for the health of all Americans.

Do we really have confidence in government's ability to make these decisions? Does its manifest inability to protect us from the swine flu do anything to inspire such confidence?

Not so far!