>Every discussion I have with Americans about healthcare leads directly to these imagined totalitarian futures, as if "everybody" knew that this was what happens. I don't understand it. Where did you all learn this narrative?

Pre-WWII footage of Nazi health programs, Aldous Huxley's Brave New World, the movie Soylent Green and pretty much everything William Gibson has written. We've seen just about every distopian outcome imaginable.

Star Trek counters this to some degree, but it's considered "nerdy".