And since bluesky seems to lack an edit button... also, the private health insurance market for policies other than short term has utterly collapsed since the ACA. Any attempt to even find a private individual policy ends up diverted to healthcare marketplace options by the insurers themselves.

Urban and coastal areas have a larger percentage of higher paying jobs with benefits. This one doesn't seem too tough to explain, really.

That's true, also. It wasn't a political statement about poor countries. Calm down.

If you actually think I was trolling, the lengthy response is even more irony.

Any study in a country poor enough to fund a good large-n controlled study may lack external validity anyway.