ETOPS is not just some rubber stamp for a particular model of airplane that manufacturers self-certify (hello, 737 MAX debacle), but rather a process applied to (airframe, engine, airline). You have to service particular engines to particular standards to be allowed to fly ETOPS, and it depends on the airline. I could go to the store, buy a 777 and hire 4 ATPs and fly a 777... but I wouldn't be allowed to fly it ETOPS, for example.
All in all, the program seems massively successful to me. It saves fuel, which means cheaper flights and less CO2 being generated. That's a good thing. The main downside seems to be medical emergencies; I remember some stories about the aircraft that flew EWR-SIN... it has some special corpse compartments to stash away the inevitable deaths that occurred 9 hours away from an airport. (It had 4 engines, but engines don't perform heart surgery on passengers.)
The reality is that engines are pretty reliable. 2 is the right number.