Yes, we're all selfish and incapable of thinking of others and of our communities. Humans are like that, so maybe that's not a useful description of the problem, i.e., just "be nicer!" or "just get along!" are probably impossible not only because they cut against human nature, or the nature of any animal (including ants and bees to some extent), but because there's no clear way to implement them. We as American citizens have not been given any choices where we can engage with each other and our communities in anything other than an every-man-for-himself, sauve-qui-peut, zero-sum-game way. The British used to be worse than us, but they changed their system. The French will jump on any chance to one-up -- that's their character -- but they usually collectively do not.
We have been consistently told that it's dog-eat-dog, we have the best "system" in the world, we have consistently beaten, jailed, and killed any and all who disagreed or espoused a different way. We have consistently maintained that not only would it be incompatible with our perfect, better-than-anybody system to take care of each other in terms of better-than-third-world infrastructure, transportation, housing, health care, accessible to all, not just the wealthy, entitled, or their lackeys and sycophants, but that it would be impossible full stop. Where inroads have been made, they have been made grudgingly at best, and with little if any thought to long term fiscal maintainability (as if we were actually TRYING to prove that it wouldn't work, with an eye on running things into the ground, saying "we told you so" and rolling everything back a couple centuries -- which looks like it's about to happen).
Germans and Japanese are excellent bureaucrats. Americans are not. We have to work with that. The 1% have 90% of the power, money, and resources. We have to work with that. Our wealth and infrastructure has been built and continues to be built on the slave or near-slave labor of blacks and to a lesser extent Chinese and other "immigrants." The secret fear has always been that the bottom will drop out of our economy if these people are given meaningful rights fair employment and access to goods and services and resources. This is never discussed but has always been there, i.e., that our system won't work if certain people aren't kept down, and the whole system has been designed to do so. This is called the "Mudsill Principle" or Lenin's "American Exceptionalism" explanation of why America never goes down into Marx' price competition spiral, i..e, there is a permanent downtrodden class that acts as a shock absorber, never benefits from social reforms, increased wages, etc.
Everybody just "be better," or "the 1% needs to give away their money" all just seem silly, and shamey-blamey, and sounds just like the South Park: Underpants Gnomes episode.
Why are the roads shitty and congested? Maybe because the people with the money who makes the decisions go to work by helicopter, or have a driver. Work with that -- just saying "that's bad and unfair" doesn't fix anything. What is the path from where we are not to an acceptable other place. It's not a key to the candy store. We actually have a current situation, a certain amount of resources, people who have a say about those resources, and things we actually have the capability of accomplishing -- and if we actually do it right instead of unilaterally whining about how things aren't the way we want them, we may actually get, through some kind of cooperation, a better solution than most people thought possible.
One thing about health care right now is that it does not actually fit into the "American way of doing things." There is no real price competition, there is no oversight of monopolies (like power companies are, by the way), and it's self-regulated. Doctors can do whatever the hell they want, other doctors are the ones who say if it's right, and they set the standards. None of this would be acceptable in any other industry...or country. Lawyers are the same. Insurance companies and accounting firms have been doing this kind of stuff for centuries -- we know pretty well how many people are going to get sick from whatever disease and what treatment they'll need in a given year. The Japanese take it a step further, recognizing that, which is a very, very basic accounting concept, i..e, that it's a kind of "sunk cost" (I'm playing a little fast and loose here) to basically test everybody in the country with every test known to medical science, enjoy tremendous economies of scale, and then catch early so many illnesses and morbidity that it comes in cheaper than the minimum or maximum or likely cost (you dial it in) of illnesses you don't catch, which are alsos much more expensive to treat after it's "too late." Insurance companies, accountaints, and also health suppliers and workers LOVE this stuff, since everybody has guaranteed income based on population, it's nicer to test samples eight to five, five days a week than to be woken up in the middle of the night seven days a week, and in the end it's nice to be SUCCESSFUL and to actually have a positive effect on people's lives and on the community...but it's BY DESIGN -- not just "let's all be nice and stop being such selfish assholes."
Like I said, lawyers are the same. There is some minimum number of lawyers required to handle the caseload of this whole country. We may have enough, we may need more. This is a tough one, because we may have to say "y'all are gonna have to do more pro bono, and that's it," i.e.,. get the lawyers to make a law saying that lawyers have to work for free a lot more than they do now. Half my family are lawyers, but I have to admit that I don't know how much this is required, or whether they get tax cuts for it, or what. I do know that I made a major case in which I sued somebody for $8,000 in the Japanese courts, it was a process that lasted months, and I only paid $100 out of pocket to do it. Should newly graduated lawyers have to serve for some amount of time, should the government pay for law school for some in exchange for them working as public defenders and cheap law help for people who have less? We do that for doctors, so why not?
The car industry. They're our de facto transportation infrastructure. Should they be required to turn out a cheap, reliable, vehicle (like the Volkswagen beetle used to be), and have it standardized across car companies, and not make random, marketing-driven changes to the design, so that every mechanic in the country could diagnose and fix one in his sleep, and parts, spare parts, used parts, would be ubiquitous, and unless the thing was completely crushed flat and dropped in a vat of acid, it would be possible to swap out parts and fix it for cheap? The automobile industry is currently a place were free-market competition may be working against us, but it we all work together, including acknowledging that the car makers have their own needs, they need supplies, they need employees, they need to sell their stuff, we may be able to come up with a much better solution. They might even be able to make electric individual self-powered train cars, which could be purchased or leased out by municipalities with train tracks, for example -- the sky's the limit if we actually decide what we want!
I should wrap it up and get on with my life.