It may just be my cynicism talking, but it seems that it comes down to the power of lobbyists. In the US, the healthcare companies control the government. Elsewhere, the government controls the healthcare companies.

The media narrative is a factor too. Like I have extended family, friends, and work colleagues in the US, many of whom are wealthy and well-traveled and even a lot of them will still loudly assert obviously disprovable untruths like "well at least we don't die in waiting rooms like in Canada" or "at least we don't have death panels deciding who gets to have life-saving treatment" or worst of all "ehh I mean I have good insurance, and outcomes are much better here for top-5%ers, so I don't really care about the rest of the system." All while decades of TV hospital dramas depict a well-oiled medical system delivering effective and efficient care to people with nary a whisper about how it's getting paid for.

It's got to be desperately frustrating trying to fight this kind of thinking when you've got whole communities who have never even thought to question it.

My main hope at this point is with bottom-up type efforts. Let Mamdani show people that an effective city government can fill potholes and operate a few at-cost supermarkets. Let that be the start of citizens expecting more than chainsaw-waving and twitter meltdowns for their tax dollars.