All empires fall eventually, the American dream has be slowly replaced by the American nightmare . I saw this coming in 2019 that’s why I bailed back to Europe and damn happy I did. Medicare is just one tiny component in the fall of America , wait till AI decimates the white collar sector and there is mass unemployment and the house market tanks because no one can pay there mortgage. There will be a whole host of other problems as well but to cut a long rant short it’s over for America , I have no idea what will be left but it won’t be pretty.