"You mean trying to make sure that there are US citizens that do not have to go without medical care? Like this might be a problem."
The problem is not the intent (of seeing folks have access to necessary medical care), but execution of that intent (the current plan). The Affordable Care Act was designed poorly.
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"The rest of the world no longer trusts the USA and are not going to follow it to its own Armageddon."
HA!
As if America is going to 'ask' the world to follow it down the toilet.
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"Sadly most Americans know nothing of the outside world and are brainwashed so comprehensively by their own media that they have no idea how they are perceived by people outside their own country."
This is true except it's not (only) the media (which is mainly a conduit, not a source). No, blame any one who stands to make a buck offa Americans (and the rest of the world)...call the aggregate of these folks the political/corporate class...better yet, call them parasites (and, yeah, that includes Bernie Sanders...

). And, of course, blame Americans themselves for allowing themselves to be domesticated.
Having said that: as I said elsewhere in this forum, I live in America, I have no plans to go elsewhere, my fortunes are (currently) intertwined with America's, so it's in my best interest it, as nation, does well, even if it's not doing 'good'. I would prefer this to come about by way of a sane, aware, citizenry hiring sane, aware, proxies, but that's not the current scheme. So, barring national sanity, I can only count on zealous insanity (imperialism) to keep the U.S. ahead. Sad to say, but if all of 'you' have to become a ghetto so that 'I' have ready and easy access to ramen, then so be it. It's ain't fair, it ain't nice, but it is what it is. I'm sure I'd feel differently if I were on the other end, but I'm not, so...*shrug*