One problem now dwarfs all others. Our nation has evolved into what social scientists call a caste system, with 60 million affluent people socially and often geographically isolated from the remainder of the population.
The main reason for creation of this group has been taxation policies that strongly favored affluent people for the past half century. Only in America can you get a tax deduction for the interest payments on your yacht by having it as a second home. The tax code is filled with similar benefits for affluent people. Capital gains and dividends, a major source of income for many affluent Americans, is taxed at a much lower rate than earned income. The tax exclusion for inherited income was recently increased to $5 million. The most egregious part of our caste system is a severe new limitation on upward mobility. The pursuit of happiness promised in our Declaration of Independence is now much harder to achieve for those not born to the affluent class. Many people now live in fear of their personal futures instead of looking forward to their futures. The hard won civil rights from the past century have become hollow dreams in the absence of human rights.
Virtually all affluent democracies other than the United States provide universal health coverage as a matter of right to their citizens. In 2009, the Harvard Medical School estimated that 45,000 Americans die prematurely each year due to a lack of adequate health care.