The weakness of our paternalistic social system is that it leads people to believe that "government will provide" and they are no longer responsible for themselves or their family members. I am old enough to remember the situation in Canada's hospitals before universal health insurance and there was never an issue in that era of getting patients discharged.
When in practice I used to suggest that the "bed blockers" who were fit to be discharged (but family would not take them home) should be the ones on stretchers in the corridor, not the acutely ill who needed the bed denied to them, and for whom it was quite difficult for the nurses to provide the care they required.. Needless to say, administration did not agree!
Among my memories are two instances of old ladies ready for discharge but their family would not accept them, in one case her daughter refused because she was "too busy with her church work" and the other refused because she was "too busy with her dogs."