> Most people are healthy, and don't need healthcare.
On average, people who rate themselves as in "good" or "very good" health still spend $4,000-$6,000 on healthcare annually. Younger folks have kids, and deal with childbirth, ear infections, allergies, ear piercings getting infected, broken bones, etc. They also have routine illness (I had a bad cough this year, my wife had a sinus infection a few years ago, I had surgery for a deviated septum in high school). 78% of people 30-49 report that their healthcare is "excellent" or "good." 70% of folks 55-64 have at least one chronic condition: https://www.cdc.gov/nchs/health_policy/adult_chronic_conditi.... 80% of those folks, who are too young to qualify for Medicare, report receiving "excellent" or "good" healthcare.
American healthcare is really quite good if you've got employer-provided insurance. Going back to remarkable asian american facts: Japanese Americans have an infant mortality rate 33% lower than Japanese in Japan, and also live several years longer. They have Kaiser Permanente or Aetna, just like everyone else. It's also extremely convenient, especially in the suburbs. I walked into an urgent care for my kid's ear infection yesterday, and made a next-day appointment with his pediatrician for a follow-up. We also saw the pediatrician to get our daughter's ears pierced, and visit her regularly to remind our daughter to eat vegetables before dinner. When I had a cough earlier this year, I booked a same-day appointment with an app.
> The amount of money that is poured into transit, though, is a pittance compared to the amount of money that is poured into private automobiles, which is a large part of why the transit option sucks as much as it does.
This is why I used Chicago, Boston, New York, and DC as examples. These are well-funded systems. D.C.'s Metrorail has a bigger budget than Stockholm's subway, despite having half the ridership.
> The reason for why large, expensive metro areas are losing small numbers of people is probably not 'people want to drive'.
People don't "want to drive." They want low taxes, flexibility, and big, affordable houses. The average new house in the United States is 2,400 square feet and costs $275,000 ($115 per square foot). There is no urban area in the developed world where you can buy condos that large near transit for that kind of price. I bought a house on the water in suburban Maryland for $175/square foot. To get that kind of price in a city, I'd have to go to western China.