Then who pays? If your argument is that we should socialize the cost of that ambulance ride across all Americans, they won’t go for that. Americans don’t want more taxes, but more importantly, Americans deeply mistrust their fellow citizens, and don’t want to feel like they’re paying for someone else’s life decisions.

America doesn’t have the same kind of social cohesion as most countries. We’re a nation of individualists. The general feeling here (rightly or wrongly) is that healthcare costs are largely driven by your choices in life, and Americans don’t want to feel like they’re on the hook for other people’s bad choices.