Not an American here, so please correct me if my take is completely wrong. My understanding is that while the highs are possibly higher than in a lot of places, the lows are also much lower and possibly easier to reach. You could be doing perfectly fine one day, and then you get hit by a hospital bill ruining your life. It's surely a great place to be a billionaire or even just plainly well off. Except far too many people aren't and they would fare much better elsewhere.