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An updated analysis comparing healthcare systems across 20 countries finds once again that the US system is an outstandingly poor performer, summarized as being a "persistent failure" for its high costs, poor health outcomes, and premature deaths.

"Americans pay more for health care, get less in return, and remain far more exposed to illness, debt, and insecurity than their peers," the report concludes.

The report comes from The Commonwealth Fund, a private foundation focused on healthcare system performance, which periodically conducts such comparative analyses. The new report is based on 2024 data and compares the US to 19 countries, including many in Europe, as well as Australia, Canada, Chile, Israel, Japan, Korea, Mexico, New Zealand, Turkey, and the United Kingdom.

As has long been the case, the US spends far more on healthcare than any other of the 19 countries. In 2024, the US spent 18 percent of its gross domestic product on healthcare, nearly twice the average of all the countries, which was 9.3 percent. The second-highest spender after the US was Germany, with 12.3 percent.

Drilling down, the US spends far more on care per person than other countries and spends more on prescription medications. Americans are, by far, the most likely to skip medications, treatments, tests, and consultations due to costs.

US life expectancy at birth ranked third lowest, at 79 years, while the average was 81.2 years. Only Turkey and Mexico had lower life expectancies, which were 77.3 and 75.5, respectively. The highest life expectancies were in Spain (84 years), Japan (84.1 years), and Switzerland (84.3 years).

Uniquely bad

The US had the second-highest avoidable mortality rate—deaths caused by conditions that can be prevented with primary care or treated with timely medical intervention. Only Mexico had higher avoidable mortality. Similarly, the US also had the second-highest rating on years of potential life lost, a measure used to estimate premature death. Again, only Mexico had a higher rating.

The report highlighted critical weaknesses in the US healthcare system, including having the fewest primary care providers of all countries in the analysis. The US has 0.3 primary care providers per 1,000 people, while the overall average is 1.1 providers per 1,000, and the highest-ranking countries, Australia and the Netherlands, have 1.8. The US produces new physicians at one of the lowest rates and also has among the lowest hospital bed capacity levels.

The poor outcomes from America's failing health system are not evenly distributed, of course. While the US has a higher maternal death rate than any other country in the study, at nearly 19 deaths per 100,000 live births in 2023, maternal mortality for Black women in the US is 50 deaths per 100,000. The average of all the countries was 9.5, with 11 countries having maternal death rates at less than 5 per 100,000 live births. And, while the US had the third-highest suicide rate of the countries assessed, suicide rates in the rural US are significantly higher and rising. Rural Americans are less likely to have access to doctors and mental health services, the study notes.

The report notes that the US uniquely lacks universal health coverage among high-income peer countries. Mexico was the only other country in the study without universal coverage but has plans in place for universal care starting in 2027.

Overall, other countries have already come up with strategies to address the failings seen in the US health system, including reducing healthcare costs, strengthening primary care, and addressing inequities.

"What’s remarkable is not that alternatives exist, but that the United States has failed to pursue them," the study concludes.

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It's not an ideal time to be buying a new PC or doing a major upgrade. Price crunches for RAM and storage chips are making all kinds of components more expensive, and the shift to DDR5 in modern Intel and AMD CPUs means that a lot of people would need to pay money to replace their current DDR4 kits if they wanted to step up to a significantly newer, faster CPU and motherboard.

AMD may have something on the horizon for people who are looking to stretch their current PC (and its DDR4 RAM kit) just a little further. Leaks spotted by Tom's Hardware point to the existence of an "AMD Ryzen 7 5800X3D 10th Anniversary Edition," a re-release of a 4-year-old out-of-circulation CPU that might nevertheless be an upgrade for people with older Ryzen CPUs in Socket AM4 motherboards.

The "X3D" in the chip's name signifies that it comes with 64MB of extra L3 cache stacked on top of the main CPU die, bringing the total amount of L3 cache to 96MB. Workloads that benefit from extra cache—including most games—will perform much better on the 5800X3D than they do on the vanilla Ryzen 7 5800X.

The "10th Anniversary" being celebrated isn't for the 5800X3D itself, but the AM4 processor socket, which first launched in September 2016. The socket was succeeded by AM5 nearly four years ago, but AMD kept the AM4 socket around to continue to address the budget market. Higher prices for DDR5 RAM kits and AM5 motherboards themselves have helped keep the AM4 socket around since then, and while AMD hasn't released any new architectures for AM4 boards since late 2020, it has been remarkably persistent in releasing and re-releasing remixed Ryzen 5000-series CPUs for the socket.

The 5800X3D was the first of AMD's X3D releases, and it comes with the most compromises compared to standard Ryzen chips. It doesn't support most forms of overclocking, and its base and boosted clock speeds are each a few hundred MHz lower than the regular Ryzen 5800X. If you're not planning to pair the chip with a fairly fast, recent GPU from Nvidia's GeForce RTX 40- or 50-series or AMD's Radeon 9070 XT, a regular eight-core Ryzen 7 chip from the 5700 or 5800 series may get you better value for your money.

But for people with a high-end GPU who don't want to pay today's inflated prices for a good kit of DDR5 memory, a re-release of the 5800X3D could help stretch that old Socket AM4 system for just a few more years.

AMD hasn't officially announced pricing or availability for this chip yet, but the apparent existence of retail packaging suggests its launch may be imminent. An Indian retailer listed the chip for about $310, though we'd take this with a grain of salt given ongoing disruption from tariffs, fuel costs, chip shortages, and other factors. Used versions of the 5800X3D start between $450 and $500 on eBay as of this writing, so anything lower would be a relative bargain, provided AMD can keep the chip stocked.

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As you’re drifting off to sleep, there are things you want to envision and things you definitely don’t want stuck in your head. A mental image of fluffy sheep nimbly hopping a fence is welcome, but something that looks like a creature from the depths? Absolute nightmare fuel. When the new Mercedes-AMG GT 4-Door Coupe debuted late last night, I thought it looked like a catfish raised entirely on a diet of bong water. Now that I’ve had a few hours to come to grips with the design, guess what? It’s somehow worse than it first appeared.

Right, before we dig into what makes this car so hideous, it’s time for some context. In 2014, Mercedes-Benz revealed a front-mid-engined coupe called the AMG GT and it was glorious. Seeking to cash in on that brand equity with the shamelessness of a comic book film, 2019 saw Mercedes-AMG rework the E-Class platform into a five-door liftback called the AMG GT 4-Door Coupe, which essentially became the de facto replacement for the CLS. With a choice of straight-six or V8 power, it had some muscle behind the posturing and looked handsome enough.

However, for the second-generation AMG GT 4-Door Coupe, Mercedes-AMG is going electric – just as the sort of people who buy six-figure luxury performance cars are expressing a thirst for the internal combustion engine. It’s definitely a bold move, one that probably would’ve been more successful five years ago, but it’s hard to deny that the specifications are impressive.

Specs like 1,153 horsepower. Yep, a one, then a comma, then another one, followed by a five and a three. A three-piece array of axial flux motors imbues the top-spec Mercedes-AMG GT 63 4-Door Coupe with output to rival the 1,234-horsepower Lucid Air Sapphire and the 1,019-horsepower Porsche Taycan Turbo GT. Granted, there is a caveat here: Full power is only unlocked during launch control at 80 percent state of charge. Still, when the stars align, Mercedes-AMG claims it can sprint from zero to 60 mph in two seconds flat, which is quicker than you can say the name of the vehicle, and it’ll allegedly run from a dead stop to 124 MPH in a mere 6.4 seconds. Oh, and the motors themselves are tiny, with the front motor measuring 3.5 inches wide and the rear motors each measuring 3.2 inches wide.

If that’s far too much, there is a lesser Mercedes-AMG GT 53 4-Door Coupe on offer with a mere 805 horsepower. You know, sensible grocery-getter stuff. Beyond shock-and-awe output, this EV features serious cooling capacity, rides on triple-adjustable air springs, steers all four wheels, offers multi-stage traction control, and can be optioned with interlinked hydraulic dampers for active roll stabilization. The battery pack boasts 106 kWh of usable capacity, and there’s silly 600 kW DC fast charging capability that will be a struggle to exploit in the real world due to most fast chargers tapping out at or below 350 kW. There’s even a drive mode with fake shifts and a simulated V8 soundtrack, a bit like what you get in the Hyundai Ioniq 5 N.

It’s certainly a monumental technological showcase for Mercedes-AMG, but there’s one big problem: This car redefines the word ‘gopping’ because in just about every way, it’s the most hideous thing to ever feature an AMG badge. Let’s start at the front, where a number of sins are committed.

For the past eight years or so, the so-called Panamericana grille with its vertical slats has been a Mercedes-AMG trademark. At face value, that’s fine, but the integration here leaves a lot to be desired. It seems extruded from the bumper, which introduces a whole lot of strange surfacing. If you look at other upper grille-less cars like the Porsche 911 or the Xiaomi SU7, you’ll notice that where the hood tapers down at the front, the upper edge of the bumper continues the same curvature before increasing its severity as it transitions to a vertical plane.

This AMG GT 4-Door Coupe does the opposite of that, like it’s got a permanent Kylie Jenner lip kit on. To sort of cheat this transition, Mercedes-AMG has gone with the most loathed visual element of the moment, a light bar spanning both headlights that looks like something you could buy off of AliExpress. Oh, and of course, the headlights have three-pointed stars in them, as if the dinner plate-sized emblem in the grille wasn’t enough. The end result isn’t simply a catfish mouth. If you cover either the headlights or the lower bumper, this thing looks like two different cars. That’s not attractive, full-stop.

In contrast to the front, perhaps the profile of the new AMG GT 4-Door Coupe being a bit generic isn’t a terrible thing. It has the same sort of modest dash-to-axle, upward lower flank crease, strong haunches, and sloping roofline we’ve seen from a litany of other electric sedans, although again, the devil is in the details. Each extreme of the greenhouse features a slab of plastic, and while the modestly sized triangle simulating a quarter window is relatively inoffensive, a small quarter-light would’ve been more tasteful than the triangle of plastic in the front door window aperture.

Right, brief break from visual whiplash over, onto the rear, which is about as minging as the nose. That taillight configuration is truly something else. Six round elements, one three-piece arc over the top, smoked horizontal elements presumably for indicators and reversing lights, all set into a giant sea of shiny black plastic. So much shiny plastic, the round elements with their garish inlaid three-pointed stars look lost in a void. It looks like the back of the car is wearing ski goggles, and that’s not even the bit that really annoys me.

The Mercedes-AMG GT 4-Door Coupe is going to be an expensive car. Pricing hasn’t been released yet, but the old combustion-powered model tops out north of $200,000. Given the inclusion of a panoramic moonroof, why couldn’t Mercedes-AMG paint the strip of trim between the moonroof and the rear window black for a cohesive look? It’s been done before on the W213 E-Class, Volkswagen offers a more extensive and expensive painted treatment on the current Golf R’s roof to match the tinted moonroof, so why couldn’t Mercedes-AMG finish this detail off properly on its five-door flagship?

In case you were expecting this thing’s gurning mouth and unresolved arse to give way to a gorgeous interior, you may want to temper your expectations, because everything is computer. Quite literally, there’s not one physical control on the entire face of the dashboard, with a three-screen array dominating everything like dropping an entire bottle of the sort of hot sauce you’d find at Ace Hardware into a bowl of oatmeal. You do get some drive mode selectors and a small bank of controls for stuff like hazard warning lamps and stereo volume in the console, but the sheer reliance on screens really cheapens the cabin of the AMG GT 4-Door Coupe. The metal speaker grilles, quilted leather door card inserts, and exposed carbon console are utterly lost in the digital assault.

Now granted, there have been cars with stars on the front unveiled to a dearth of applause. Stories from the debut of the R231 SL recount an awkward silence after the sheet was lifted, and the Dodge Intrepid-shaped EQS didn’t exactly set the world alight. However, being mocked on debut is a new one. I posted two photos of the new AMG GT 4-Door Coupe to my own Instagram story, and as you’d expect, it was viewed by many colleagues. Perhaps the most suitable reaction came from a very respected auto writer via private DMs, which have been anonymized to protect the guilty:

“Wait, this is real?”

Unfortunately.

“Holy shit.”

Indeed, the overarching reaction to this engineering marvel is one of incredulity that Mercedes-AMG would release something this visually unresolved, this garish, this bewilderingly fish-faced. From a marque that’s staked over a century of reputation on elegance, letting a car like this out of the studio is embarrassing. Mind you, this was always going to be a low-volume car, and Mercedes-AMG only needs a few dissenting opinions for the AMG GT 4-Door Coupe to be a modest success. As Autopian editor-in-chief David Tracy wrote in Slack, “I think it looks fantastic.”

Top graphic image: Mercedes-AMG

 

The post The New 1,156-Horsepower Mercedes-AMG GT 4-Door Coupe Feels Like A Hideous Joke appeared first on The Autopian.

The Colorado Supreme Court ruled Monday that Children’s Hospital Colorado should resume providing gender-affirming care to transgender youth.

In a 5-2 decision, the state’s highest court concluded there is sufficient evidence that Children’s violated state antidiscrimination law when it suspended gender-affirming care earlier this year in the face of mounting federal threats.

The majority ordered the case be returned to a lower court, where it said a judge should issue an injunction requiring that Children’s resume the care, which in this instance includes prescriptions for things like puberty blockers or hormone therapy.

Writing for the majority, Justice William Hood wrote that Children’s — or CHC, as Hood shorthanded it — had continued providing puberty blockers and hormone therapy to cisgender children when medically appropriate. That made the decision to stop providing them to transgender youth discrimination.

“CHC’s decision to suspend medical gender-affirming care to youth denies petitioners the full and equal enjoyment of services based on gender identity,” he wrote.

In a dissent, Justice Brian Boatright wrote that the majority opinion too easily dismisses the context in which Children’s made its decision: threats from the federal government that could result in the entire hospital system being shut because of its provision of gender-affirming care. Justice Carlos Samour joined the dissent.

Boatright wrote that the majority’s opinion “completely minimizes the reality of the situation. Furthermore, it brushes off these drastic consequences as speculative.”

It was unclear Monday how quickly the lower court judge would take to issue an injunction or whether Children’s would resume care ahead of that order.

“Children’s Hospital Colorado is reviewing the court’s ruling and assessing our next steps,” the hospital wrote in a statement. “While we do not have updates to share at this time, we will provide guidance in the near future.”

The attorneys for the families did not immediately return a request for comment.

Tumultuous months

The decision caps a tumultuous 15 months for transgender youth who receive prescriptions for gender-affirming hormones or puberty blockers at Children’s.

In February 2025, Children’s first suspended gender-affirming care following an executive order by President Donald Trump that vowed to crack down on the practice. The hospital resumed providing care later that month after a federal judge blocked the order.

In July, the U.S. Department of Justice subpoenaed Children’s for sensitive patient medical information, employee personnel files, internal emails, billing records and other documents are part of an investigation into the off-label use of prescriptions for gender-affirming care, though the government acknowledged it had no evidence of wrongdoing.

Children’s is fighting in court to quash the subpoena. A magistrate judge has recommended that the subpoena be quashed, calling the DOJ’s investigation “a smokescreen for its true objective” of trying to end gender-affirming care through intimidation. A final order has not yet been issued, though.

Then in December, U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. issued a declaration finding that gender-affirming care for youth is neither safe nor effective. The declaration said hospitals that provide the care could be punished, and an HHS official announced later that month that Children’s had been referred for investigation to the agency’s inspector general.

As a result of the ensuing investigation, Children’s could be kicked out of the Medicaid system, which would mean the hospital could not collect payment for care provided to any Medicaid patient for any purpose. Roughly half of the patients seen by Children’s are covered by Medicaid.

Exclusion from Medicaid, though, would also have broader implications, which is why the rarely used federal sanction is known as a death sentence for hospitals. Children’s officials have said their contracts with private insurance companies would collapse, as would their partnerships with doctors. The hospital could lose its accreditation, and state regulators may as a result pull its license.

Care suspended

Children’s announced just after the New Year that it had again suspended gender-affirming medical care for trans youth under the age of 18. While the hospital has continued to offer mental and behavioral health services, it stopped writing new prescriptions for hormones and puberty blockers to trans youth.

The hospital does not perform gender-affirming surgeries and has never done so for patients under 18.

This time, several transgender patients and their families sued Children’s, arguing that the decision violates a state antidiscrimination law. They said Children’s has continued to provide hormone therapy and puberty blockers to cisgender youth when medically appropriate, and they said the sudden halt to care for transgender youth had devastating consequences to their kids’ mental and physical health.

Several parents said their kids’ mental health worsened dramatically, and at least one child talked of suicide. Parents said they worried about what would happen if their children “de-transitioned” and went through puberty inconsistent with their gender identity.

“It’s hard as a parent to be told by the same provider that this is the care your child needs, and see firsthand the relief that this care gives your children,” one parent, known in court as Denisha Doe, said following a hearing in February. “It truly is lifesaving. And then to have that same institution turn their back on you in this way feels like, well, my child’s life is expendable.”

A lower court judge ruled in February that the families would likely be able to succeed in proving discrimination and in proving that they’ve been harmed. But the judge ultimately sided with Children’s, denying the families’ request for an injunction that would force Children’s to resume care.

Denver District Judge Ericka F. H. Englert wrote that granting the injunction would place Children’s at risk of federal punishment and “would pose a grave danger to the public interest that is greater than the danger to plaintiffs.”

Appeal to the Supreme Court

The families appealed to the Colorado Supreme Court, where justices appeared split on the question during oral arguments in April.

One question that loomed large during the arguments was about the threat Children’s faced. If the justices were to order Children’s to resume care, how likely is it that the federal government would punish the hospital?

While the appeal was pending, a federal judge in Oregon said he would block the declaration by Kennedy that threatened punishment for gender-affirming care. Based on that, an attorney for the families said during arguments before the state Supreme Court that the risk of punishment was “completely imaginary.”

But Children’s has continued to insist it would risk federal sanction by resuming care. The hospital maintained that argument even after the Oregon judge expanded his ruling to preclude any federal effort to kick a hospital out of Medicaid because it provides gender-affirming care.

Children’s instead pointed to the Department of Justice investigation, which continues to generate legal fights over subpoenas issued to hospitals across the country.

“The Department of Justice’s latest attack reinforces the shifting and unrelenting nature of its efforts to use potential civil and criminal liabilities to attack providers of gender affirming care,” the hospital wrote in a filing to the state Supreme Court earlier this month.

But attorneys for the families suing the hospital were skeptical, saying fights over subpoenas issued to other hospitals have “no relevance” to the lawsuit.

“Petitioners respectfully request that this court follow the law of the state of Colorado and prohibit the hospital from refusing to provide gender-affirming care to children because of their gender identity,” they wrote.

“An uncertain trail”

Hood opened the majority’s opinion by calling the case “unusually fraught” and writing that the decision came “with sympathy for the petitioners, respondent’s employees and representatives, and the trial court that had to blaze an uncertain trail.”

But, in analyzing the issue, Hood rejected how the lower court weighed the harm of requiring Children’s to resume care. He wrote that “strict numerical comparison” of the people who might be harmed or helped by a decision was the wrong approach when it comes to claims of discrimination.

“Were it otherwise, minority groups would always lose,” he wrote. “But that is not the law.”

Hood wrote that, if the federal government were to try to punish Children’s for providing gender-affirming care, the hospital could ask the courts to intervene. That rejected an argument by the hospital that federal administrative rules would preclude judicial review prior to the hospital being kicked out of Medicaid.

“At this point and before this court, those threats remain speculative,” Hood wrote.

Finally, the majority concluded that Children’s could not use the federal threats — and Kennedy’s declaration against gender-affirming care, specifically — as an excuse to discriminate.

“The Kennedy Declaration may have influenced CHC’s decision, but it doesn’t absolve CHC of responsibility,” Hood wrote.

In his dissent, Boatright wrote that he does not believe Children’s violated state antidiscrimination law. That’s because Children’s didn’t suspend gender-affirming care because the patients are transgender but because of severe threats from the federal government.

“It was a decision driven by the direct threat to the viability of the entire hospital,” he wrote. “Based on the record before us, I cannot fathom that CHC would have made this call if the consequences of the Kennedy Declaration were not so severe.”

He also criticized the majority’s conclusion that providing drugs used in gender-affirming care, like puberty blockers, to cisgender youth for other conditions is an indicator of discrimination.

“While treatment for gender dysphoria and hormonal conditions like precocious puberty can both consist of puberty blockers, this does not make these treatments one and the same,” he wrote.

Colorado Attorney General Phil Weiser, whose office joined the lawsuit in Oregon that led to the judge there blocking Kennedy’s declaration, praised the state Supreme Court’s decision.

“With today’s Colorado Supreme Court decision, Colorado families are finally going to get relief after months of uncertainty over whether their children would get the lifesaving care they need,” Weiser, who was not involved in the Colorado case, said in a statement.

Weiser said the decision, along with the one in Oregon, “should give Children’s Hospital Colorado the direction it needs to resume gender-affirming care and I hope the hospital will not delay another day.”