Considering some of the UN’s historical selections, I don’t put much trust in anything they come up with anymore.
Do some research on the index. It’s very mathematical and objective. Other quality-of-life indexes return similar results.
All the countries above us offer universal health care, btw.
Re: Presidential fiscal policy; the only big issue I have with GW is that he started a war while cutting taxes for the wealthy. Leaving the lower classes to shoulder the burden (and the dead).