You are right that there has been a problem with NHS dentistry because of the way the contracts have been handled. This is not the result of NHS cost cutting but of the choices made by dentists, who are independent contractors. The issue is gradually being remedied. In the meantime, there is certainly no problem in my area. There are plenty of NHS dentists around. Dental insurance is, like any other medical insurance over here, far, far cheaper than in the US. Incidentally, despite these low costs, only about 8% of people here consider it necessary to take out medical insurance and many of those are on corporate plans designed to allow complete freedom of choice in timing for elective surgery.

Things like requiring people to make changes before certain operations (such as losing weight before knee replacements or stopping drinking before liver transplants)is not an "indirect" way to avoid doing them, but a sensible medical practice. You in the USA set a lot of store by personal responsibility. Well, the NHS does occasionally ask that people take a bit of responsibility for their own health. In fact, it offers quite a lot of support for people to do just that. There is very little point in treating conditions brought about by lifestyle with both a poor chance of success because of the patient's physical condition and a poor future prognosis because of lack of will to change that lifestyle.

Your characterization of this kind of responsibility as avoidance of responsibility is, quite simply, wrong. I think many people in the US recognize that you need a bit more personal responsibility in your own system. I know a couple of American physicians who certainly agree with that.