The Question

Split image showing a gleaming Scandinavian city streetscape alongside a busy American urban area

The United States generates more total economic output than any nation on earth. Its GDP is roughly $28 trillion — larger than the next two economies combined. This is a remarkable fact that Americans are rightly proud of. But it is also, in an important sense, the wrong metric for measuring how well ordinary people live. Total GDP says nothing about how evenly prosperity is shared, how long people live, how affordable healthcare is, or how secure people feel in old age. By those measures, the picture looks very different.

Several countries already outrank the US on GDP per capita — the average income per person — when adjusted for purchasing power. Luxembourg, Norway, Switzerland, Singapore, and Ireland are all above the United States on this measure. Our prediction is more specific: we give 55% probability that by 2035, at least five countries will demonstrably exceed the US on a composite standard-of-living index that includes health outcomes, life expectancy, income distribution, and social security. Some of them are already there.

What the Evidence Shows

American life expectancy is 76.4 years — lower than Cuba, lower than Slovenia, and far below the 83 years enjoyed by residents of Japan, Switzerland, and Australia. The US spends more on healthcare per person than any other developed nation — nearly twice as much as Germany, France, or the UK — and gets worse outcomes on almost every measure. This is not a natural disaster. It is a policy choice that has compounded over decades.

The Gini coefficient — the standard measure of income inequality, where zero means everyone has the same income and one means one person has everything — puts the US at around 0.41, higher than Russia, China, and every major Western European economy. The top 10% of Americans own approximately 67% of the country's wealth. The bottom 50% own about 2.5%. This is not the profile of a country where prosperity is broadly shared.

"The United States is exceptional in the developed world for combining high average incomes with high inequality, poor health outcomes, and weak social insurance. By any comprehensive measure of wellbeing, it ranks well below its GDP position would suggest."

— OECD Better Life Index — Comparative Wellbeing Report, 2024

The Nordic countries — Denmark, Norway, Sweden, Finland — consistently top international rankings for happiness, health, and quality of life. They have lower average incomes than the US, but far lower inequality, near-universal healthcare, generous parental leave, affordable childcare, and robust pension systems. The median Dane is not richer than the median American, but they are considerably less financially precarious and live longer. Singapore has overtaken the US on nearly every quality-of-life metric while maintaining high-growth economic dynamism. Australia combines high incomes with a functioning universal healthcare system and a mandatory superannuation retirement savings scheme that the US's 401(k) patchwork cannot match.

"America is the richest poor country in the world — extraordinary wealth at the top, extraordinary precarity at the bottom, and a middle class that is slowly hollowing out."

Why This Is Happening

Healthcare costs are uniquely destructive in America. Medical bills are the leading cause of personal bankruptcy in the United States — a phenomenon that simply does not exist in any other wealthy nation. The combination of high costs, incomplete coverage, and no universal fallback means that a serious illness can financially wipe out a middle-class family in a way that would be inconceivable in Germany, Canada, or Australia.

Inequality has compounded for forty years. Since the 1980s, the gains from economic growth in the US have accrued overwhelmingly to the top of the income distribution. Productivity has risen steadily. Median wages have barely kept up with inflation. The social contract that translated growth into broadly shared prosperity — strong unions, progressive taxation, robust public investment — was dismantled piece by piece and never rebuilt.

Other nations have quietly built better systems. While the US was debating whether government should play a role in healthcare, retirement, or childcare, other countries were iterating on these systems for decades and getting them right. Singapore's sovereign wealth fund model. Australia's compulsory retirement savings. Denmark's flexicurity labor market. These are not utopias — each has its own problems — but they have narrowed the gap between top and bottom in ways the US has not.

What Could Happen

US Maintains Raw GDP Lead While Falling Further on Wellbeing Most Likely

The political gridlock that has prevented major healthcare reform, pension reform, and inequality reduction continues through 2035. The US remains the world's largest economy in total output, and high-income Americans remain among the wealthiest people on earth. But on composite wellbeing — life expectancy, financial security, healthcare access, happiness — the gap between the US and leading countries like Denmark, Australia, and Singapore widens. The five-country threshold is crossed not because the US collapses, but because peer nations continue to improve faster.

Policy Reforms Narrow the Gap Possible

A sustained period of political will — driven perhaps by a crisis in the healthcare system, or demographic pressure from aging Baby Boomers demanding better social insurance — produces real reform. Medicare expansion, drug price negotiation, and a strengthened retirement system narrow the wellbeing gap with European peers. The US doesn't become Denmark, but it moves meaningfully toward the middle of the pack on health and security outcomes. The five-country threshold is only barely crossed, if at all.

Rapid US Decline Accelerates the Shift Less Likely

A combination of factors — a severe recession, a healthcare system crisis, or the compounding effects of inequality finally hitting a tipping point — accelerates American relative decline faster than structural models would predict. More than five countries pull clearly ahead by 2030, not 2035. The US drops out of the top ten on multiple composite wellbeing indices. This scenario is less about other countries doing something dramatically new and more about America's existing structural vulnerabilities finally cascading.

Our Assessment
We assign 55% probability — slightly more likely than not — that by 2035, at least five countries demonstrably outrank the US on a composite standard-of-living measure. Several of them arguably already do. The core dynamic is not American decline in any dramatic sense — it is the continued improvement of peer nations whose healthcare, retirement, and social insurance systems are compounding advantages that the US's raw GDP cannot compensate for. America generates extraordinary wealth. It is increasingly poor at converting that wealth into the things that make ordinary lives actually good.

What Can We Do

International policy conference with delegates from multiple countries discussing quality of life frameworks

This is fundamentally a political problem dressed up as an economic one. The resources to build better systems exist. What's been missing is the political will to use them differently.

Measure what matters, not just what's easy. GDP is easy to measure. Life expectancy, healthcare access, financial security, and social mobility are harder but more important. Governments that track composite wellbeing indices — as New Zealand, Scotland, and others have begun doing — make better decisions because they're accountable for a broader range of outcomes.

Look seriously at what works elsewhere. Australia's superannuation system, which compels employers to contribute a percentage of salary to every worker's retirement account, has created near-universal retirement savings where none existed before. Singapore's MediSave system uses mandatory health savings accounts to ensure everyone can pay for basic medical care. These are not radical socialist programs — they are pragmatic mechanisms that work. American policymakers have largely refused to study them seriously.

Fix the healthcare cost crisis. The US pays two to three times what peer nations pay for identical medical procedures, devices, and drugs. The gap is not explained by better outcomes — it is explained by a broken pricing system. Expanding Medicare's ability to negotiate drug prices, establishing reference pricing for procedures, and extending healthcare coverage to uninsured Americans would be the single highest-impact intervention available.

Invest in the bottom half. The countries that outperform the US on wellbeing are not uniformly richer — they are more equal. Raising the minimum wage, strengthening union rights, expanding the Earned Income Tax Credit, and investing in early childhood education are all policies with strong evidence bases that would raise living standards for the half of the population that America's average income figures systematically obscure.

Sources
  • OECD — Better Life Index, Comparative Wellbeing Data, 2024
  • World Health Organization — Global Health Observatory, Life Expectancy Data, 2024
  • World Bank — GINI Index and Wealth Distribution Data, 2023
  • Federal Reserve — Distribution of Household Wealth in the US, 2024
  • UN Sustainable Development Solutions Network — World Happiness Report, 2025
  • Forecast The World Research Desk — 800+ data sources