Social programs only exist to the extent they do as a wealth subsidy. Paying so low or scheduling hours such that people are on government benefits is subsidizing what the wealthy should be paying people. Medicare and Medicaid are ways to give money to middlemen instead of just directly paying for care. Until Biden they literally weren't allowed to negotiate prices as every other form of health insurance does. All of these are bullshit concepts. Student loans aren't even run by the government just paid by us while a third party servicer reaps the money and as you note shouldn't exist. All developed countries do miles better in all these areas than the US.