"Anyone trying to picture a US “universal healthcare”, I want you to think back to your last trip to the DMV. " - I think the truth in this, is the USA needs to

"Anyone trying to picture a US “universal healthcare”, I want you to think back to your last trip to the DMV. " - I think the truth in this, is the USA needs to solve the meta problem of having well-run government systems, before it can attempt universal healthcare. For various reasons, while the USA is excellent at many things, its poor compared to other countries, at running public services. It seems like a self-fulfilling prophecy to me. Americans don't believe gov't can run things well, therefore they don't even try, therefore it doesn't happen. When Ronald Reagan famously said the 9 scariest words were "I'm from the gov't and I'm here to help" , that message would have landed flat and made no sense to Europeans and Canadians, but in the USA that fits with people's experience. One big thing is the lack of an independent civil service in the USA. If I understand correctly, in the US when a new administration comes in they effectively fire all the managers and put their own people in charge. Whereas in the UK for example, there's an independent civil service who operate by a code of unbiasedly serving whatever administration is in and implementing their policies. While this means that sometimes there same people in their career implement one thing, then roll it back, then re-implement it, as governments change, and this may sound inefficient, in practice this means the public services carry on running reasonably well despite the wins and crazinesses of certain politicians that come and go.