You seem to be focusing on specific problems with C/C++. I don't really care about that, all I'm saying is that prefixing names are equivalent to placing them within a namespace, in practice, and theoretically come to think of it. You can easily define a bijection between namespaced symbols and prefixed symbols. Requiring the full prefixes are simply a tad more verbose, essentially equivalent to using a fully qualified name for symbol.

foo.h defines i64 as “long” and bar.h defines it as “long long”. Now what?

This would break legacy code. I had one employer with a bool type that was a 32-bit integer because of obscure alignment issues. This is why _Bool exists and the bool typedef has to be brought in explicitly with stdbool. You can't just go and usurp popular short type names. The standard reserved *_t and _[A-Z].+ for this purpose. People have been writing portable code with the expectation that future standards aren't going violate that promise and break things.