I totally agree that culture is a big factor. I just think the conversation in the US around healthcare is kind of limited to pro or anti “Medicare for all” when there are actually many ways of doing things which do not require a single payer. Japan is just one example, Germany is another.

Obviously we shouldn’t just exactly copy the system of other countries, but it’s equally shortsighted to not learn take away anything from other existing systems. The possibility for universal coverage and higher cost efficiency without the need for single payer I think is a valid thing to take away from those examples.