You would think that people living in what we commonly refer to as "the developing world" are worse off all round. Their economies are less advanced, their governments more unstable, the politicians more corrupt, and their health care system cannot provide the best care. You would think that, and you would be wrong.
Take healthcare for example. America has no doubt one of the best healthcare systems in the world; meaning, the best doctors, hospitals, machines, and the latest drugs. But Americans are paying through the nose for it. The HIV drug Atripla costs over USD 2200 for a one-month supply. The generic version made by Indian company Cipla is only USD 189 a month but apparently not covered by American insurance companies. The difference is so big that even Europeans with health plans which reimburse less than the full amount of a drug may be saving money by buying the generic version.
But consider this: in many developing countries, like Thailand, Brazil or India, the generic version is available for USD 35 a month and even less. The difference between 2200 and 35 can hardly be explained by the gap in GDP. It can only be explained by greedy pharmaceutical companies and a badly designed American law. Yes, someone had to do the research (the pharma industry's most cherished argument) and file the patent. But 60 times more expensive is just ludicrous. It doesn't make sense. Not if you have just lost your job and your insurance ran out.
On websites like poz.com, the forums are full of articles from Americans who find themselves in just that situation. Thousands of Americans who lose their jobs also lose their access to medication. Thousands upon thousands of Americans have much worse access to medical care than the average patient in Brazil, Colombia, India, or Thailand.
Once you stop HIV medication for too long, drug resistance and a number of life-threatening complications may develop. For many cancer patients, HIV positive persons, and many others, losing a job is a death sentence. And losing your job in America is much easier than in most countries. Indeed, most developing countries are doing a better job of looking after their citizens than America.
So every time a president calls America the "Greatest Nation on Earth" I cringe. The State of the Union address is a good piece of fiction and propaganda. But it's got nothing to do with the state of the union.
The greatest nation on earth leaves its own citizens to die because of corporate greed, faulty laws, and lack of compassion. The greatest nation on earth leaves a large portion of its population without access to even a basic standard of living. Income equality is exacerbated not only because the rich are getting richer, but because more and more middle-class citizens are becoming impoverished, e.g. because of expensive drugs. Imagine paying USD 2200 a month in order to survive. No you can't.
That's why the Affordable Care Act, although still not an ideal solution, is one of the most important pieces of legislation ever for Americans. Its website has finally worked out its quirks. Transition between health plans is a headache, but runs smooth in most states. Obamacare may finally turn the "Greatest Nation on Earth" into a developed country.