Americans are also the fattest and least active 1st world country.
In places where public healthcare exists, there is also a huge amount of voluntary personal health responsibility. People look after their health, and expect the same of their neighbors. The current state of Americans would be an unreasonable burden on public healthcare.
That being said, taxes pay so much for healthcare, that we'd probably still be able to pull it off.
That's a cost that is incurred towards the end of life without any 'trying to prolong life' involved, a surgery to do the repair is frequently going to immediately make the person more comfortable.
And there's all sorts of similar things that just happen more often to older folks.
Don’t look to us for any ideas how to do your healthcare!
And since no other country with a huge diversified economy is willing to run external deficits large enough to meet foreign demand for reserves, the dollar is pretty much the only good choice. There just isn’t enough gold to clear trade in a $80+ trillion global economy.
This is merely viewing the same thing from a US-centric perspective. From a rest of the world perspective, the largest competitors in EU were destroyed in WW2 (deservedly so imo), China was nowhere and India was impeded first by British colonization and then by Bretton Woods which only focused on EU nations.
America is ahead but make no mistake that the gap is large only because WW2 destroyed other nations and Bretton Woods system was the first step in prevention of other nations from building up rapidly.