I see you citing a study that appears to be about the inadequacy of the USA system. You could read that and decide it means the whole system is inherently broke

I see you citing a study that appears to be about the inadequacy of the USA system. You could read that and decide it means the whole system is inherently broken, but you could just as easily see that as an indictment of the US system and a need for reform or a replacement with the parts that work better in other countries.