No I would not say the United States should bare the burden, but I do not think any of the other medical systems could exist in a vacuum without the United States.
However, I would be the United States could exist without the medical systems of the rest of the world.
As a result saying that the United States should learn from the other system's "success" seems perhaps to neglect that then innovation may slow.
But that is a lot of speculation with no facts or studies to back up my assertions there.

It would seem that if that was true then another insurance company would just rise up. take a smaller cut for their profit, and reduce costs to patients and win the market. And we would stop using the aforementioned major insurers who threaten to drop cancer centers mentioned in the summary of this story, driving them out of business, or forcing them to change.

So all that brings us back to your original post on social institutions.
My primary issue with government social institutions is being forced to contribute to them.
I am all for a private social institution for healthcare not run by the government, where people can voluntarily contribute their money to a pool to help cover each other's medical bills. The institution would have some operating costs, just like the government run ones, but could be non-profit or something, no share holders answer to and have to bleed cancer patients to line their pockets.

ChatGPT (which could be making things up) tells me that the breakdown of healthcare spending is as follows:
Government programs: 43%
Private for-profit insurers: ~20%
Private non-profit insurers: ~8%
Employer self-funded plans: ~13%
Out-of-pocket: 10%
Charity & philanthropy: 2–3%

If that is true then it is hard to point the finger at Private for-profit insurers being the problem with the United States spending excess.

"RTO" stands for Recovery Time Objective, which is the maximum amount of time a system or business process can be offline after a disruption before causing significant negative consequences. It's a crucial metric in disaster recovery planning that defines the target time for restoring critical functions after an incident.

If people are too poor to save, they are also too poor to have 12.4% of every paycheck taken from them for Social Security. The catch is they cannot use that money when they need it most it is locked up until retirement, if they live long enough. I agree some would be tricked out of their savings if left on their own, but forcing everyone into a one-size-fits-all system just guarantees the poor lose control of that money by law, instead of by bad luck or bad actors. But I agree, there are people that will need help saving and a system that encourages it.

I fear that the United States Healthcare systems high cost drives medical innovation.
I understand the US still leads in medical innovation and many other countries may benefit from, while perhaps not carrying the cost of development.
If we were to mimic other countries "better examples" we might end up stifling the system that gives us the medical advancements we enjoy.

However, it seems there is a lot of room for improvement from reducing malpractice costs but capping litigation, and in affect reducing excess tests and procedures ordered by the practice of defensive medicine to avoid getting sued. Allowing more people to practice medicine to increase the supply of medical providers reducing cost with more supply. Addressing medical billing complexities to reduce administrative overhead. And throwing out drug patents as well, because I am not convinced drugs are the answer to our medical issues anyway so nothing lost there.

The sad thing is the outcomes, especially with dollars spent...but I am not sure that is a medical issue, but more a lifestyle choice we as US citizens make from our nutrition to our activities, or lack their of really making us sick and medical science can only mitigate that so much. Or just that we have the money to throw at medicine but the returns are pretty limited.

You are correct it is a bit dramatic perhaps to go to the guns; but the whole system is backed by force that will be enforced with guns. Most likely they will garnish my paychecks, freeze accounts, and put a lien on my house. Maybe eventually they will haul me away for tax evasion, and if I refuse to go there will be guns involved. But no it will probably never get that far because I want to avoid the guns, or they can extract enough pain on me without pulling out the guns. But I know they are there!

Maybe I am wrong and Medicare is more efficient than insurance companies.
But I do not think a profit motive hurts efficiency, and no one forced anyone to pay the insurance company.
Either way, efficiency as high a value to me as liberty is; and Medicare is built on the perhaps efficient theft of my money.

No worries, thanks for the kind reply!
I laid out my alternative in a comment below: https://slashdot.org/comments....
I will avoid repeating it here again in the same story and would love any feedback you have there.

I believe you are right, any social safety net provided [by the government] is going to [rightly] be considered socialist in the US. And I think that is okay, and honest. So what I would love is for a movement not provided by the government, but private. People can still pool their money together for a cause, but not be compelled to do so. We do not have to wait for universal healthcare to come down from the federal government, lets build it from the ground up in the community today collecting money and paying for everyone's medical bills today.

I see the two options offered today seemingly often labeled left and right: Government social safety nets that many scream "socialism" at, and insufficient private social programs to address the demand for social safety nets. My issue is the left seem to want to grab more power and do not really solve the issues. And the right pretends to want to block the left power grab but fails to solve the issues the way they say the should be solved.
But at least with something like homelessness I have seen great private programs address the issue. Unfortunately it is kind of addresses a symptom and not the root cause which seems to be 90% drugs, 5% crazy, and 5% legit fell on hard times.

I agree, even if everyone pinched their pennies and did not buy in excess and was perfect with their spending, there would be those who had to chose to eat instead of save for retirement. And it seems Social Security will eventually fail in its current form and requiring dipping into other tax pools or a restructuring of some sort.
But if people can lose Social Security fees out of their paycheck today and still eat, then it would seem there is enough money in their paycheck to eat and save for retirement?
However I do suspect if we handed them back their Social Security fees that little of it would go into savings, and most of it would go into eating better or beyond though.
As a result we would end up with a lot of people not able to retire or headed out to the streets to beg without intervention.
I would just at minimum love for a system that was not forced on people to get the job done.

Yeah, the forced part is the problem.

Yes, your risk pool will never be large enough to fully absorb the rising costs of modern healthcare. Trying to fix health insurance just by expanding the pool or throwing more money at it won’t work. And beyond that, I take issue with forcing people into the system in the first place

Interesting you would use the example of robbery. Because Social Security is legalized robbery. It forces me to pay.
Laws should protect my rights, not violate them.
It is best if people eat well and get exercise. But I do not want a law that forces them to do so.

We have not tried my lottery/saving system yet...maybe it will work.
But this I would love to dig more into and know little about.
Just know I am against the forced part of social security, even if it is amazing and works; which I am not convinced of either.

If people love it so much, then make it voluntary, and they should keep contributing, no issue. If the few of us that do not love it stop, we do not get the benefits, nothing loss.

Families are incredibly “efficient” when they work; no bureaucracy, no payroll tax, direct support, and tailored to the person’s needs.
But sadly families are not universal; not everyone has kids, not every family can afford it, and not every community is healthy.

I can see an argument for that Social Security is more universal and reliable, therefore framing it as efficient. Traditional/family/community safety nets are more organic and direct, but inconsistent across society, arguably least efficient.

But I find it laughable to argue the federal government or any government is efficient. Maybe a dictatorship.

Either way, my value is not efficiency, but liberty.

I see the power hierarchy as something from the top down view like federal government => state government => county => city => municipality => community => family => home => individual.

My highest value is the individual.
Anything needlessly removing power from the individual, even in the name of efficiency, is something I hate; and by that value does not make sense.

It’s not about comparing years worked to years retired — Social Security isn’t structured that way. What matters is how much you pay in versus how much you get out. On average, a worker who lives to the average life expectancy usually does receive back at least what they paid in (sometimes more, especially lower-income workers, because of the benefit formula). But that’s only possible because the system isn’t saving or investing your contributions — it relies on current workers paying for current retirees. That’s why it faces shortfalls as the worker-to-retiree ratio shrinks. That is why it is a Ponzi Scheme.

Busted I did not read your Wikipedia link at all and for some reason decided you were pointing at Social Security.
Sorry about that.

My primary issue with government social programs is being forced to pay into them.
Second I keep hearing, from people who supported and then looked into them, that while well meaning they often hurt more than they help.
Healthcare being one of those examples.

Of course I can cherry pick instances where the UK or Canadian healthcare systems seem to fail.
From first hand experience of watching Canadian woman cross the border to Minnesota to have my mother deliver their babies because the doctors up north had maxed out their salary for the year and went on vacation. Or the Youtube video of the lady wanting some treatment in the UK but the public healthcare not paying for it, but if she paid for it she loses her public healthcare.

I do not care for people being forced to do something, even if it is in their best interest.
I also do not believe that government is very good at managing anything.

I would much rather see those who were really passionate about social services create private alternatives.
Give people back their taxes to contribute to private alternatives.
I would much rather see people willingly contribute to good programs then being forced to pay into bad ones.

I do think we unfortunately need social programs today, and may always need them.

But your point stands, the US has some very popular social programs that a lot of people even on the right will fight for.

That makes sense, a lot of people do not have a dime to spare for savings.
However they are still being robbed of their social security contributions nonetheless.
So instead of them being forced to contribute to social security, I would rather they have the option to buy into a lottery/saving system I proposed or simply spend the few extra dollars today that is being stolen from them for social security. I could imagine that the few extra dollars could go a long way for them to lift themselves up and make more. I can also imagine it would just get frivolously spent and then at the end of their working carrier they are looking at begging with no safety net.

So yeah, I think we need something to help those not able to save even if they wanted to, and push those in the right direction that could save but choose to spend today without worrying about tomorrow.

Ideally I would love for everyone to have a minimal level of healthcare, if not everyone have access to the maximum level available.
I am not convinced a system that forces others to pay in to it is ever going to accomplish that.

I do not care for people being forced to do something, even if it is in their best interest.
I also do not believe that government is very good at managing anything.

I would much rather see those who were really passionate about social services create private alternatives.
Give people back their taxes to contribute to private alternatives.
I would much rather see people willingly contribute to good programs then being forced to pay into bad ones.

I do think we unfortunately need social programs today, and may always need them.

It seems to me that the math still does not work out.
Increasing taxes has a limit, eventually the Ponzi Scheme still fails.

But my primary issue is being forced to enter into the Ponzi Scheme in the first place.
I could see a scenario where the sun swallows the earth before social security fully costs everyone 100% of their paychecks.

Ha! Accusations are confessions my friend.
True I am motivated by not wanting to see people begging in the street.
I live close to the homeless shelters in my city and it is pretty sad at times; annoying at other times when they steal my Amazon packages.
I volunteer at a center that helps get people off the street, not probably because I directly cared about the people; but more so that I did not want to see them begging.
Now it is hard not to care once you learn their names and hear their simple requests.
But it is frustrating then to be scolded and told they will just go spend that dollar you handed them on drugs and pass out on my sidewalk later.
Sadly, if they died and disappeared I probably would not think too much about it since I would not see the bodies or know the faces.
I would excuse it in my mind if faced with it that they made bad choices.

But I can imagine getting to my old age and whether through bad choices myself or bad luck or a bit of both not having the means to provide for myself.
That fear drives me today to save and build a support network.
It also drives me to take care of the older people in my support network.
I am currently supporting a friend of mine who is collecting his social security and lost his entire savings in a pig slaughter scam.
The frustrating thing is I warned him it was sketchy as I drove him to the crypto ATM where he last saw his cash.
But he has a roof over his head and is not going hungry.

But yeah, it comes down to my own empathy for sure. I would not want to be begging on the street and I see myself in others, so I help because it makes me feel better. I turn my head when it is overwhelming or I feel I need to take care of myself and ignore some eyesores as well.

But I would like to think that now, I do not just want everyone to die once they stop working so I do not have to pay social security.
Maybe it is just because I do not want to have to die when I hit retirement either, or because I have friends who are that age and older I do not want to see die.

I would love to talk alternatives!

Foremost I would hope that old people saved some money and can provide for themselves.
But I understand we cannot 100% count on that, and even if every old person had tried to be responsible things can go sideways.

So next I would hope for traditional "safety nets" of family and community to kick in.
Where old people would have had children and contributed to society and their children would be responsible and take care of them, or their community would have the means to provide.
But again, I do not expect those would be 100%.

We could keep going down the list of "private" people or entities that would jump in.
I know they exist and have seen them help, but will assume they may not be enough.
Not enough in that we are not satisfied that old people are being adequately cared for to the standard that makes us comfortable.

My primary issue is being compelled with the threat of violence.
I fully expect that if I try to avoid paying social security taxes that eventually a gun would be pointed at me and my money taken away by force.
That is my primary issue.
I would rather people willingly paid into a Ponzi Scheme knowing that if the whole thing fails that was the risk, and they have to accept living on the streets hoping for one of the aforementioned private people or entities to help them out.

My proposed alternative would be to convert social security to a lottery/saving system.
You have the option, pre-tax, maybe limited by what you can put into social security today, to buy lottery tickets. Perhaps automatically setup on payroll like social security.
A lottery ticket is two dollars, one dollar goes into a savings account, the other into the pot. There is a random drawing every week or so and whoever wins gets the pot. The savings is harder to access with rules like other retirement accounts with ages you can get access and special circumstances to borrow against it early and what not.
The savings are invested in something that would hopefully gain interest.
So when a person reaches the age they would get social security their savings start kicking in.

The hope would be that responsible people save already and do not gamble and would be good to go without social security. I know plenty of people who have accomplished this today.

The other people love the idea of a quick buck and already throw money into Powerball and Megamillions, so their irrational hope of getting rich quick that most likely correlates with lack of savings would then result in them gambling and saving.

As for social security, I am willing to forfeit whatever I have put in today if I never have to pay another dime into it. So slowly raise the age and lower the payout with enough warning so people depending on it today, or counting on it being their tomorrow can still get it; and those with enough runway can adjust their retirement plans and invest the extra money they will start receiving for retirement or buy lottery/saving tickets.