There is, however, a significant minority of really horrible, angry, violent, and generally racist people who feel deeply and ideologically threatened by the social contract on which these systems rest. And because of some unfortunate quirks in the American electoral system, they wield a level of political power that vastly exceeds their numbers. In a properly representational system, they'd be just as aggressive, ignorant, and self-defeating as they are right now. However, the body politic would be largely insulated from their rage, allowing us to safely get on with the design and development of a decent, cost-effective system.
In other words, we're being plagued by a really nasty infestation of trolls, and it's making progress in general pretty damn difficult. The good news is that this, too, shall pass. In demographic terms, this problematic political outlook is the rooted in the reactionary portion of the generation that came of age during the Civil Rights era. Their bigotry translated into a life-long political identity that has done everything it can to resist, if not reverse the "loss" they suffered in the wake of Jim Crow ending.
The Drug War is probably the best example of their continued effort to put a boot on the necks of black people. It's worth noting that the militarization of US police forces, combined with an exploding private prison industry, took root in the former Confederate states before spreading outwards to damage the rest of the nation. And of course, opposition to any kind of drug legalization remains strongest in places with the deepest histories of institutionalized racism.
The same perspective that says the state should be used as a weapon to harm black people also says the state should not be used to protect or help them in any way. Thus, the vitriolic opposition to any kind of welfare program than benefits black people. Keeping them out of the health care system was part and parcel of this larger push for institutionalized white supremacy.
But again, all this is a generational reaction to the 1960s, a particularly divisive and transformative time in American politics. When the generation that dedicated itself to obstructing the movement for greater equality finally passes from the stage, there won't be another one with either the size or the depth of hatred to maintain the current levels of opposition. So even in an electoral system as warped as ours, the certifiably batshit-insane won't be able to maintain their dominance. That's bad news for everyone with a stake in Fox News, great news for everyone else on planet Earth.
At that stage, with the right wing of the baby boom dead and buried, America will be able get on with the long-delayed work of creating a more-perfect union. Given how much pent-up demand there is for policies that reflect intelligence, fairness, humanity, and decency, I suspect demand for change - and the consensus to support it - will appear quite swiftly. So it's nice to know that there are already well-developed models we can refer to when the time comes.