Just checked the transcript, Picard never say the highlighted portion. And while I'm sure some do so, I have a problem with every one of the hundreds of billions of the people in the Federation choosing to do so. That's turning the entire Federation into a version of "The Planet of Hats." It's the old Trek argument, there's Picard's statement in FC, and then we see and hear people in the Federation doing otherwise. Or medical decisions would be between patient and doctor, with the patient in control, and without a government or a corporation being involved. Look one could nitpick. in the future businesses will sell equipment and pharms, governments will regulate safety, but (again) neither has to be directly involve with the individual treatment of any given patient. That type of direct involvement for the majority of Americans really only goes back a few decades.
There's no evidence in the show that universal access to basic survival needs including health care is some kind of 'happy lie'. It's a fantasy show, just let it be fantasy. You can suspend disbelief that the human race really can intellectually evolve even if you don't believe it yourself. Universal healthcare in the Trek universe would be a lot easier to provide than in the real universe since they live in a world of abundance where there are no patents on cures. It's interesting to me that everybody is associating Critical Care with capitalized health care when I see it as the other extreme, the extremes of government controlled health care. Look at the 'treatment coefficient' system, this is a method of rationing that prioritizes access to resources based on the government's calculation of how valuable a person you are. This is literally what people lied would happen under Obamacare to scare people about it. Critical Care is like if all the anti-Obamacare propaganda were actually true as opposed to outright lies purchased by the insurance and pharmaceutical industries. The treatment coefficient system is 'death panels'.
Actually that's a good way of looking at it too. I think myself and others saw it as an indictment of the US health care system based on the fact that rich people tend to have really good health insurance, while tons of people in the US have no insurance at all. But your way of looking at it is just as valid.
Which episode please? I can't recall the matter being established one way or the other. But we do see pharmaceuticals being negotiated for. And there's the large medical display in the Enterprise-D's sickbay that includes a readout for "medical insurance remaining."
There's nothing special about Earth. It's a normal Federation member world just like any other. In fact his exact phrasing is "The acquisition of wealth is no longer a driving force". He did not say it's no longer ANY force.
While the meaning of the word "wealth" could be stretched to mean any amount of money, having a society where many people have denounced avarice, doesn't mean that they don't work for financial compensation, and then spend their income to they own purposes (support themselves, etc.). In TVH, Kirk see a women feeding coins into a vending machine and says "they're still using money." It's obvious from TOS that money in some form exists in the 23rd century. Kirk is referring to the physical coins being used. When Picard says there no money, I seriously think he's exclusively referring to physical money. It the only way I've been able to put together all the money/no money dialog in the show.
Watching Critical Care again, I noticed that at the beginning that Gar has a TC of 15. He doesn't live on the planet, nor is he a native of it and Chellek is well aware that he's nothing but a con man. So I don't get why he has a TC at all, especially one that is relatively high. The TC calculations also don't take a person's aptitudes into account at all, as Tebbis was shown to have an aptitude for being both a doctor or a mechanic. Not smart to ignore that, as its been said before "What if the cure to cancer is in the mind of someone who lives in a ghetto?"