Healthcare across the entire west is crumbling, and not through defunding. It's driven by demographic shifts that nobody has a real plan to fix.
The demographic explanation simply does not hold water when routine healthcare is not available.
In the US dental is considered a seperate insurance for most. So there's a separation for whatever reason meaning using it to disprove the demographic theory for "regular" healthcare might be valid
And dentistry is why people in England are scared of changing the model for NHS healthcare, because we see that dentistry is fucking awful for huge numbers of people.
The problem with the NHS is not the model, it's the funding.
(It’s universal with 70% of costs paid by the government)
Japan put in place many strategic constraints on their system to achieve this result. Hard decisions most countries would revolt at, doctors unions would strict at, and westerns would call broken.
But at least the system does it's job and is not projected to collapse. You can win votes, or you can design a functional system. You cannot do both.
That’s why I questioned the idea that demographic issues are going to prevent the West from solving this problem. A little bit of political will and some signatures is all it takes.
See for example Japan having very few public trash cans but also very low amounts of litter, or even very low wage workers taking pride in their jobs, or Japan having both extremely low unemployment and also low/no wage inflation for very long periods of time. Japanese business culture is one of seeing a duty to the public/consumer in a way that most other capitalist countries do not. They have a cultural aversion to screwing people over and ripping them off, and in working very many extra unbilled hours because it’s expected of them - they’d never have the same healthcare failure modes as in other countries
Some time ago I read 2 different books on healthcare systems, both very detailed, the authors having compared in-depth the many styles of healthcare systems in existence in addition to having relocated for some time to some of the locations to get a personal look. And despite all the complexities involved in such comparisons, both came to the same very basic conclusion: Healthcare systems are a reflection of the mindset of the country's citizens; Americans won't get universal healthcare until the average American believes that other Americans deserve it.
The USA is weird in comparison: you get immediate healthcare even if you can’t afford it, with everyone else just paying for those who can’t or don’t want insurance. If Americans don’t want universal healthcare because they don’t think some Americans don’t deserve healthcare, they are doing that really wrong.
In case you're wondering why having to foot the bill for all those uninsured hospital visits doesn't make the "taking responsibility" thing super obvious, it's because most people aren't aware of how much they are paying for it. Like many things here, uncompensated medical care is ultimately paid out of a combination of many different local, state, and federal sources. While we are all paying for it somehow, it is not obvious to an individual how many of their dollars went to it. Therefore, while unfortunate, many believe that an increase in monthly healthcare premiums (they know exactly how many of their dollars go to that) means they will be paying more overall, not the same or less, because they are either unclear on how much of their money is going to the uncompensated costs now, or they don't trust that their tax bills will actually decrease.
We're once again at a place where most Americans believe healthcare coverage should be guaranteed, but are miles apart on who they trust to actually handle it. [1]
[1] https://news.gallup.com/poll/468401/majority-say-gov-ensure-...
These examples heavily downplay the public health, safety, and behavior progress the West has made. In the US, litter, graffiti[1], and smoking were all greatly reduced over the past half century. The male smoking rate in America is half of the male smoking rate in Japan.
I think the idea that the Japanese form of capitalism is more benevolent than the rest is also a bit rosy-eyed. Statistics on hours worked aren’t great for Japan. It’s arguably not a good thing that low wage workers are prioritizing work. You say that there’s an aversion to screwing people over but in the same sentence you’re saying that low wage workers are being exploited and convinced to work unbilled hours.
[1] Jusr do an image search for “New York Subway 80s”