[kibwen]

> "the richest country on Earth"

This statistic is misleading. The US is only the richest country on Earth if you consider the mean wealth. By median wealth, the US is ranked 26th. The wealth gap is enormous, and if you're in the upper echelons of the pyramid your health outcomes are vastly better than the clownshoes shitshow that the rest of the country is subjected to.

[nescioquid]

The critique is perhaps not relevant here, since it suffices to say that the country's wealth can afford a health care system not held together by "spit and twine", irrespective of how that wealth is presently apportioned. The wealth gap is, as you say, enormous.

In fact, the wealth gap is but a reflection of the underlying cause of the problem: legislators corrupted to the interests of the donor class at severe cost to the actual constituents of those legislators.