Now, there's a whole administrative system that drives up prices and puts a ceiling on availability and quality of care; with most Americans being (relatively) ill-traveled, ill-read, and fed a news product that beneath the packaging is some combination of entertainment and fear-mongering, it's easy for one to believe there's just something in the air that makes an NHS-style or even a German-style system impossible here.
Then, if you were around for the 2008, 2012, and 2016 elections, you'd have seen presidential candidates arguing about whether someone should have to pay for someone else's well-being. And it's not a debate along the lines of class—it's tied up with identity politics and a broader debate around the welfare state. Advantaged and disadvantaged communities alike are full of people who see how things are, and, knowing that it takes a lottery win to move up the economic ladder and a bad week to fall down, are skeptical that next time it'll be different.
Doesn't help that most Americans will never have the opportunity to get even an hour of education in macroeconomics, unless it's buried in disconnected lessons about individual economic downturns, nor that education on probability doesn't happen until second-year calculus (which is similarly rare in high schools), nor that most Americans don't learn about the mechanics of Medicare until their fifties or sixties
