On the counterfactual of the government potentially doing less, I speculate that it would be politically difficult for the government to copy ODH’s business model under which 2⁄3 of total costs are covered by patient fees. Specifically, my understanding is that user fees for public healthcare were dropped in the early 2000s, although as a practical matter the public system isn’t always free. Reinstating official fees only in certain areas probably wouldn’t fly well politically. So the government would likely have to spend several times what ODH does to set up the same health centers, and that is probably relevant to assessing the odds that it might counterfactually do so.
On the counterfactual of the government potentially doing less, I speculate that it would be politically difficult for the government to copy ODH’s business model under which 2⁄3 of total costs are covered by patient fees. Specifically, my understanding is that user fees for public healthcare were dropped in the early 2000s, although as a practical matter the public system isn’t always free. Reinstating official fees only in certain areas probably wouldn’t fly well politically. So the government would likely have to spend several times what ODH does to set up the same health centers, and that is probably relevant to assessing the odds that it might counterfactually do so.