It is worth noting that while people under age 65 in the U.S. live in a heavily market - dominated economy where poor employment
outcomes mean poverty and a lack of access to health care, almost everyone
over age 65 has most of their healthcare paid for by Medicare, (a FICA tax financed, single payer system that pays providers
more or less the same rates as private insurance companies and has few cost
controls),
more than half of their nursing home costs paid by Medicaid, (which is stingy in how
much it pays providers and moderately means tested), and receives enough of a guaranteed income from the combination of Social Security and SSI payments to keep the poverty rate for people age 65 +, (even if they have no retirement savings of their own), above the poverty line, regardless of the state of the local economy.