The problem in the U.S. is the spending of the surplus. If in '83 the Greenspan Commission would have created a lockbox and invested the surplus 50% stocks/50% bonds there would be no problem with social security. Medicare is more difficult but solvable. The military has socialized medicine and no one complains about it - it is a system that works and doesn't demand an inordinate amount of resources. Is there something to be learned ?
In the medical area, I've become intrigued with the results of cash only clinics and doctors who don't accept private or public insurance. Third party payers hide the true cost of treatment from the consumer so you no longer have a price conscious consumer. Areas of medical treatment where third party payers are not involved, such as lasik surgery and cash only practices, seem to be the only places where the cost curve is bending downward.