I think just not enough people believe the system is bad enough to warrant a drastic political action. If the majority considered it to be dire, that would be reflected in elections. In Ontario we have kept voting for a government that continues to undermine the system. Sounds like the situation is similar elsewhere too. Perhaps a part of the reason is that medical staff are burning themselves out to keep things from failing instead of letting them fail. From the outside, as well as from above, it looks like things "seem to be working." I'm afraid a lot more people need to get burned for us to make a U-turn.