Most social services function something like a pyramid scheme. You need more people paying in than taking out. There are ways to tweak the balance a bit, almos

Most social services function something like a pyramid scheme. You need more people paying in than taking out. There are ways to tweak the balance a bit, almost all of which have to do with finding efficiencies that reduce administrative costs- replacing in person visits with doctors with video calls to nurses, moving manual-process-intensive paperwork to less-manual-intensive electronic billing, that sort of thing. Unfortunately, there's only just so much you can do when a greater percentage of the population is drawing on benefits and not working than there are people working and paying taxes. If the balance swings too far, something has to give- rationing access by adjusting age limits, declining certain types of care, reducing benefits, that sort of thing.