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Which seems to me quite a bit different than the ones I see on TV....
1.  The 'total command of everything' was a quip.  Among other quips...
2.  But I am convinced that many Americans (not you) would like our government to move far, far in a paternalistic direction.
2a.  Associated with this is their low view of the average American in the street.  Gun control is an easy issue through which you can compare these two world views, "trust Average Joe or trust the government."  Educating kindergartners on bisexuality.  Most of the issues that badly divide the flyover states from the population centers.
2b.  Associated with this is income redistribution "in the interests of fairness," even if it harms our economy, as President Obama put it when answering a Q about higher tax brackets reducing tax revenues.   Obviously, socializing 1/6 of the economy is currently the most feasible move in that direction.
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On the most expensive health care system, and 42nd-best care, I'd like to see the metrics by which we documented the 42nd-best claim.  My mom's experience, and mine, was more like "American health care is in the 22nd century already."  That hasn't been my experience.
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What we should move *to,* that's a great Q and quite an issue.  Perhaps Dr. G could chime in.  My first thought would be to make it a lot cheaper by reigning in the trial lawyers and adjusting cultural expectations on how aggressive doctors should be about adding year #84 to the life of a very sick person.
Or not.
Your ideas are always very interesting Diderot.  This is one with legs:  "What exactly do we do?"  Perhaps we could narrow that question.  About what?  About our expenses?