There has been a similar situation in the UK, in my time the NHS was treated religiously in some sectors, struck me as weird.
Things change and if it was not a Government thingy it would have changed a long time ago, but it does not have to. I can think of no end of comaonies I had dealing with when I started work which are not around any longer, or certainly not in the format they were.
So we had years of Cons being blamed, one of the reasons Labour won, they of course promised the earth and of course can not implement it as it was never practical. Amusingly they have done a few things that the Cons suggested and were derided foir, the trend continues.
I am no fan of the US system, seems a leach that keeps on growing consuming more and more.