I would be not so sure about a frame for an answer rinsi. I don't know thoroughly the USA health care system but, as it often happens, we, the Europeans, tend to forget that the USA are, in fact, 50 States. With a much greater integration of course than EU but always 50 States. I remember a friend of mine from Virginia, for instance, once told me the health system of her residence State was quite different from the Texas or Florida ones.
So said, once stated my ignorance about the topic, of course the health system problem, not only in Spain, forms a part of a wider picture which shows a multinational attack against the central sovereign authority of the states. This can be considered under a good number of different points of view. The ideological clash between different macroeconomics theories, the historical series etc.