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The missing Americans: Unprecedented US mortality far exceeds other wealthy nations
(www.sciencedaily.com)
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I'm sure those all contribute, but a lack of universal healthcare is almost certainly the biggest issue. Even with most Americans having some kind of health insurance, we are discouraged from seeking care, our system favors treatment of problems over prevention of problems, and we often receive the legal minimum of care instead of the best possible care so that insurance companies can make more money.