Honestly, I don't think the USA does a terrible job at managing these systems it's just funny to me how the song and dance pretend is such a thin facade. Something like UBI is too idealistic and out of reach for policymakers until the USA moves away from the concept that if you are poor, you are inherently evil.

Really all the USA needs to do is make a fork of the VA healthcare and fix the rough-around-the-edges and start offering it as a well-controlled attractive option in the market that is taxpayer funded, maybe roll it out for union workers and blue collared folk first for maximum political appeal