Plenty of bribes to go around. For politicians, press, "think-tanks".... They make sure system is not changing.

I think it comes down to the healthcare trilemma: cost, access, and quality (or "cutting-edge-ness"); the US optimizes for quality and access, while countries with universal healthcare optimize for access and cost. You can only pick two.

Regulatory capture of our legislature and regulatory bodies, intense bribery, proof of need legislation, and people consistently providing an obviously corrupt system with more money and power thinking that somehow, magically, the people who’ve obviously been corrupt and dishonest will be made angels when given more money and power.