The city government hasn’t yet figured out how to do well many of the tasks it has already been assigned – provide pothole-free streets, corruption-free building permits, and high-quality public schools.

Rather than focus on fixing those problems, though, a Democratic mayoral candidate, Fernando Ferrer, on Friday unveiled a plan to expand city government’s responsibilities in a life and death area – health care. He wants to add another 290,000 children and 200,000 adults to the ranks of those whose health insurance is provided by the city, and he wants to spend $55 million a year on “community healthcare centers” throughout the city. And he’s keen on requiring employers in certain industries to provide health benefits to employees – thereby making it even more expensive to create a job in New York City.

Mr. Ferrer’s health care plans aren’t entirely bad medicine. He speaks of cracking down on Medicaid fraud, an important advance for Democratic politicians who are too apt to believe that fraud exists only on Wall Street but never in government-funded health or welfare programs.

But absent from Mr. Ferrer’s plans are free-market-oriented solutions such as health savings accounts that give consumers discretion over their health care dollars. Absent is any talk of opening the competition to private hospitals, currently prohibited in New York, of the sort that have reduced health care costs in other states.

If Mr. Ferrer’s thinking on health care is going to amount to “let the government do it,” he’s going to be greeted with plenty of skepticism. Some government-run hospitals in New York do provide high quality care already, and no doubt there are success stories to be found in some city schools. There are honest employees to be found filling potholes and approving building permits, too.

But the city’s taxpayers have too much experience over the years with poorly provided municipal services to leap at any health plan that would dramatically expand the role of a city government. City Hall has a way to go before it is trusted as the family physician. If after four years as mayor Mr. Ferrer has all the city’s current responsibilities running smoothly – pothole-free streets, corruption-free building permits, and high quality public schools – then it might be time to revisit the issue.