One thing that is difficult about living in the USA is the health care system. Other countries have universal health care where citizens are encouraged to seek medical assistance whenever needed and the cost will be primarily if not entirely covered by the government. But in the USA, health care is up to the individual to pay for; the citizen will only receive assistance depending on the insurance plan that they purchases.
Because medical bills are up to the individual to pay, it heavily discourages people from seeking out medical assistance when needed out of fear of how much the bill will cost. This arrangement of the health care system makes it difficult for those with low incomes because they are less likely to be able to afford any kind of expensive procedure or long-term treatment. This then forces some people to opt out of coverage entirely because they cannot afford the monthly cost.