From 1990 - 2020

Every 1st world country has had universalized healthcare (socialized/government provided medicine, covering 100% of the population).

America has been the notable exception.
Why has America not had 'Universalized Healthcare' like the other 1st world countries?

Because The Owners Of The Country Don't Want That
It is in the best interest of 'The American People' (The Masses, The Poor) for there to be 'Universalized Healthcare' of some sort.
It is in the best interest of Insurance Corporations, as well as Private Equity Firms That Own Hospitals, for there to *NOT* be Universalized Healthcare.
It just so happens to be the case that from 1990 - 2020, America has been a society where Insurance Corporations and Private Equity Firms

wield far greater power over determining laws and public policy

than 'The American People'.
Most of 'The American People' (70%) support 'Medicare For All' (or at least some version of universalized healthcare).

As of 2020, this is not even on the table, so far as those who manage the US Government are concerned.
Why?

Because Insurance Corporations have bribed most Democrats and all Republicans in Congress to vote against Medicare For All.

Bribery is done via 'Campaign Donations' and Lobbyists.
TLDR:

'The American People' want Universalized Healthcare (Medicare for All)

The Donor Class (Insurance Corporations) do not.

The Donor Class wields far more power over the US Government than 'The American People'

so Universalized Healthcare has not and WILL NOT happen.
Joe Biden, Kamala Harris, Donald Trump, and Mike Pence

are all explicitly against

Medicare for All
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