Sure it is necessary to understand the problem to fix it, I am not denying that. Sure, “refusing to pay” vs “paying a lot and accomplishing fuck all” are different problems. But the context of this discussion is “can US healthcare system be objectively called third-world-like” which it can. Whether it is bad because of X or Y reasons is not relevant and comments like the one I responded to, come off as trying to diminish how dire the situation really is.