Seeking diverse perspectives on the future of the U.S. healthcare system, we analyzed 6,594 YouTube comments to April 2021 New York Times video titled “What Does US Healthcare Look Like Abroad?” with a million views. Qualitative coding, with AI-enabled semantic network visualization and linguistic analysis, produced triangulated insights. U.S. system concerns centered on access, affordability, and medical debt-related financial distress. Described as inefficient and profit-driven, with a substantial influence from pharmaceutical lobbying, lacking universal coverage, the U.S. system’s design misaligned with the core values of many Americans. Acknowledging the need for U.S. healthcare reform, the commenters proposed solutions: government negotiation of drug prices; tax redistribution to aid vulnerable populations and middle class; advocating for public opinion shifts to view healthcare as a fundamental right and to stop equating universal healthcare with socialism or communism; and political action. Unique commenters with comparative health system knowledge often spoke negatively of the U.S. system, but some praised its service efficiency and support for the unemployed. The semantic network visualization confirmed widespread concerns, ideological debates about reform directions, and consideration of societal, political, and economic contexts. Narrative and experiential comments with system critiques (vs. not) scored higher on authenticity. Problem-solving comments with solutions (vs. not) scored higher on being analytical. The YouTube platform promises policy-relevant insights for health system architects and reformers. During the pandemic, it served as a global town hall where U.S.- and non-US commenters compared healthcare experiences, advocated for change, and corrected each other’s misconceptions.