This will be a fundamental impasse between us. And I doubt we'll get very far if we try to have discussion here, but I'll offer a response to which you can reply or not should you feel the need to.
A belief in centralized gov't power leading to better outcomes is (I assume) fundamental to your world view as it is anathema to mine.
The social democracies of Europe with gov't provided healthcare are supported by two things which are basically nonstarters here. Higher levels of taxation at all income levels, and lack of military spending.
There aren't any with living memory of a time before these things existed. I would assume you can't really imagine a world without these things as you've been living with them for so long.
But the umbrella of American security guarantees that allowed them to grow in the first place is going away. Europe is already beginning to remilitarize (Ger sending 5000 troops to Lithuainia for ex). The trade ensured by these security guarantees is also going away.
In my view America paid for tickets to an 80 year free ride for Europe that is now going away. I assume y'all will have to change the way you do things in the coming decades but doing so will be a slow and contentious process.
American healthcare (and education for that matter) is not a perfect system as I'm sure we can all agree. Pharma giants ludicrously over price drugs and large medical players in our system are able to capture regulation in our system in a way that further increases cost.
My blame for this is that healthcare in the US has turned into a jobs program for useless administrators. Healthcare and education aren't produced efficiently here due mostly to gov't involvement as I would argue this chart shows
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It is my belief that both the education and healthcare bubbles will eventually pop over here. The education bubble is already popping (if slowly), just look at declining college enrollment.
The healthcare bubble has a while before it will pop because one of our largest populations (the boomers) are getting into retirement and will need end of life care for years to come.
But eventually it too will pop. I think our disagreements here will be founded in a fundamental difference in the way we see the world and the way we think it "ought" to be so I don't really see us agreeing on much, which is just fine. We don't have to agree or even come to an understanding on everything.
Hope you have a great 2024 and thanks for your reply.