For the bottom ten per cent in the US, life expectancy is about 20 years less than in most other equivalent n countries at just 36 years.
Gun deaths and opiate addiction are the obvious factors making up the difference, but healthcare must also come into it.
There are few health care things which, if you’ve survived childhood, are likely to kill you before you’re 35 or 40. Drugs and guns, yes, but few health care things. That “must” is an incorrect assumption.