Greater spending on health should correlate with gains in life expectancy—but the U.S., the planet’s biggest per capita spender, lags significantly behind other developed nations by that measure. (Australians spend half as much, but live almost five years longer.) U.S. rates of opioid abuse, gun violence, and maternal and infant fatalities all exceed those in most other advanced economies, driving down average life spans. And in a largely for-profit system where insurance often depends on employment status, access to the basic care that leads to longer lives can be tenuous at best. Even people with access often feel uncared for, as we learned from the polarized reactions to the murder of UnitedHealthcare chief executive Brian Thompson.

This article appears in the February/March 2025 issue of Fortune.