I get what you're saying and generally agree with the overall point, but this specific aspect makes it worth remarking that even the model trained to be pro-Elon concedes Elon is at fault.

“Charity” is not foreign aide. Foreign aide keeps the refugees from the one chunk of wherever from overwhelming the government of their neighbour which has a knock-on effect on the price of Critical Defence Material or shipping and/or oil. That bones us, even if we hate everyone involved.

Then, afterwords, everyone has to do a ton of work re-corrupting and re-inserting their business interests into the upstart regimes. We want the Devils we know and have bribed handsomely, new bribes suck.

It has very little to do with ‘them’, per se, and everything to do with our wallets. Granted, normal business people like stability; disruption, famine, and war work very well for others. We prefer to choose when we topple regimes than having food shocks and epidemics thrust it upon us, better ROI and easier scheduling.

Why you were doing it in the first place matters, too.

Then one day hospital management changes and the next morning, they fire everyone and turn off your ventilator, not even giving you time to find another hospital to move to. Many patients suffocate to death before noon.

Did the new manager do anything wrong?

But that's not what happened. Elon Musk, a random rich guy who was not himself financing the charity, appointed himself dictator of all American spending programs. He promised his patron that he would make the government run more efficiently, but found himself unable to. Then he went around randomly breaking charitable programs in an attempt to prove that his failed government efficiency initiative was producing meaningful outcomes. That's why he is accountable (and will be held accountable) for the people his decisions have killed.

Power is always based on reciprocal obligations. Everywhere in the world, at every point in history. While modern societies try to formalize the obligations, there are plenty of informal expectations that are equally important.

Because infectious diseases do not respect international borders, someone must be in charge of international surveillance and response to outbreaks. When someone does what must be done for the common good, people tend to see them as a leader. If they stop doing their job as a leader, people interpret it as abandoning their responsibilities. And when someone fails to do what is expected from them, people will think poorly of them.