Because people in the US don't understand value, only cost. A lot of what you discuss fits into this pattern. Buy a cheap $30 printer on sale, and then spend $

Because people in the US don't understand value, only cost. A lot of what you discuss fits into this pattern. Buy a cheap $30 printer on sale, and then spend $30 more per ink cartridge for the life of the printer. A lot of people when they run out of ink literally buy a new printer, because it comes with ink, it's almost as cheap and they 'may as well'. They don't realize that it doesn't come with a full tank of ink, or that spending more on a printer means a better quality printer that lasts ten times longer. Likewise health care. People don't want to pay more (or perceive that they're paying more) in order to have a better-functioning system that works better for everyone. They don't understand that everyone paying slightly more into the pot means a health care system that doesn't turn you away because the nearby hospital isn't 'in-network' so you have to go across town for your insurance to cover your emergency. My wife had to go to the ER the other night, and she chose based on reported wait times of nearby hospitals, rather than which one our insurance would actually pay for. Likewise, not having to pay a $25 co-pay every time you go to the doctor means that you can go to the doctor more often and keep your health up to date, rather than waiting until things are dire before you cough up the $25. I've also seen lots of people buy Android phones because 'it's like half the price' of an iPhone or a premium Android, and then find out that they were never going to get software updates from the manufacturer again, that the performance was awful, and then turn around and end up buying a new one a year later. Meanwhile, people on the iPhone 5 (five years old) are reporting that iOS 10 actually works pretty well on their device and doesn't slow it down as much as they'd expected, and I know people with a Nexus 5 (three years old) who are still going strong on the latest Android updates because they paid slightly more at checkout. Fundamentally, commerce in the US has become a race to the bottom: who can offer the cheapest product without consumers realizing that it's cheap because of cut corners and misfeatures.