Same reason that does not happen with healthcare: the mindset is different. In many ways changing the system means giving up some things Americans value more than citizens of other countries.
I'd argue that some foreign examples would actually match well culturally. Take Switzerland. Highly decentralised (imagine county-sized administrations having about as much sovereignty as US states). Very high salaries. Similarly wealthy (about 20-30% higher than US median per capita PPP). Similarly libertarian (privatization is has been a favourite topic of polititians as well). Similarly conservative. Yet building a tunnel through arguably more difficult terrain (read: risk of death, costly insurance policies) cost 10-20x less per KM in Switzerland compared to the US. It did so again tunneling right through the city of Zurich, extending one of the busiest train stations in Europe with an underground station and a new large new above ground ramp. Both projects stayed on budget.
I really think that looking abroad has a point. As an example, for Swiss railway managers it has been a regular occurance to go abroad and learn from other countries what they do better and what to avoid.
The US is just a nation and Americans are just humans, like everyone else - trying to stop with the "we are special" thinking would give the US quite a boost in certain areas IMO.
Your last point rings especially true. There seems to be a whole class of people in the United States who, despite their professed love for the free market, refuse to consider any sort of marketplace of ideas when it involves public policy from other countries.
Like, its somehow completely incomprehensible to people that the Germans might have devised a better system for running trains (they build better trains, so not so far-fetched) or that the Japanese might have a better grasp on building quality public transportation than we do.
Rather, there's this idea that the American way of doing things must be the absolute best in every possible situation. Its a very damaging idea, and historically has led to stagnation and collapse (Qing dynasty China comes to mind as a great example of this).
Sometimes I feel the US would indeed be better off if the individual states were in competition with each other more. In particular I feel the mobile market in the US would work better for instance if it was carries that only run infrastructure for a handful of states rather than all.
This is what makes infrastructure cheap in Europe. The Swiss rail companies build infrastructure for Switzerland primarily (unless they are contracted out) and not for all of Europe.
Not sure whether there is any one reason, but yes, I think that more competition and more local administration is a good thing. Switzerland even has communes in competition with each other with their tax system, which IMO works well (albeit I'd like some more stringent rules).
My utopia would be an virtualized, decoupled administration system based on the blockchain and decentralized contracts. I can simply choose what org I want to be citizen of and subscribe to them. An org would itself subscribe to a set of infrastructure and get volume rebates. Each piece of infrastructure has a blockchain address - if I want to use it and I'm not subscribed, I just pay as I go. Essentially, free market meets governance. Some exceptions where IMO socialism works best: Schooling, National defense, emergency services and Healthcare. Same high standards and opportunities for everyone.
"we are special" can be a great tool for convincing people to act against their own best interests, and for yours. If you convince yourself that "our way is best" is a tautology, you also have no reason to learn much about other approaches. It's a difficult mindset to shift.
In the case of healthcare it's not because of American values directly, it's because the entire conversation has been framed in a way so the majority of Americans don't even understand what the possibilities are and the debate is entirely centered around a series of fantasy narratives put forth by lobbyists for the status quo.
I mean the whole conservative argument about the value of the free market for moderating health care costs is completely blown up by the most cursory look at the value you get for private health insurance in the UK due to the fact that they have to compete with free. But there's no attention span in the political debate to put forth an argument like that because it doesn't align with an established narrative and therefore can be triggered by a sound-bite-sized emotional appeal. You need a years-long strategy and talking points to chip away at it, but the people with the knowledge and facts to do so are not good political strategists, and the people with the time and inclination to do so all have vested interests in the current system.
> I mean the whole conservative argument about the value of the free market for moderating health care costs is completely blown up by the most cursory look at the value you get for private health insurance in the UK due to the fact that they have to compete with free.
I disagree that they have to compete with free because they effectively compete with free footing parts of the bill and that is ideal. If you take the UK and you have a private insurance (like Bupa) you don't have private insurance instead of the NHS (the public one) but in addition to the NHS.
One the one hand this means that I have the choice as a customer to go with an NSH or Bupa service, but I also know that the NHS will always take me and Bupa knows that I will think like that. Bupa knows that people are very unlikely to charge the private insurance for an ambulance (because why would I? The gov pays). However they know I will use their services when I had a mountaineering accident and need a helicopter. They fundamentally operate in largely different areas that just happen to overlap in some parts. Sometimes people use a private insurance because they don't want to wait. But that often also means they don't have to wait not because they will die because then the state system (unless it's temporarily broken) will prioritize you anyways.
I think splitting the problem into two (emergency care vs. 'lifestyle' care) would work in the US but that's not the conversation that is taking place and that is a cultural thing more than it is a problem of politics.
In Canada, health benefits take the form of a dental plan, massage, mental health services, and a lot of nice wellness treatments that are very welcome and useful, but not necessary. Calling it lifestyle care is quite apt.
Obviously, we're not living in the same "Canada". For exemple, there is a recurring problem with homeless (most generally men) with mental illness in the lower mainland since the Riverview Public Mental Hospital got CLOSED.
Canada's health care system certainly isn't perfect and it's not comprehensive. I live in Vancouver near the Downtown Eastside. I'm very aware of how much it doesn't cover in this regard (although it does pay for a safe injection site that's pretty much a miracle of public health spending).
America has institutionalized the high cost of healthcare and the healthcare lobby which profits from that is among the top 3 political donors. That maintains the status quo.
The mindset is the same as in any other country - the polls say people prefer single payer in spite of all the propaganda thrown their way.
While the UK was debating forming the NHS back in the 1940s the Conservative party fought to put in place an insurance based system largely like America has today. If they had been a little more powerful after the war the UK would likely face similar problems.
