What you call crap is a large part of the problem. Socialized medicine does not provide a driving force to improve. It would be nice if that weren't the case but reality isn't crap. Socialized medicine does not work anywhere in the world it's been tried. At best they have to rely on the massive $'s poured into R&D from the USA rather than contribute anywheres near the same level to keep improving. Take that away and the impact will be felt here as well as abroad. Like it or not, money is what drives the industry to improve itself.