Please explain to me, in simple terms, how the cleanliness of a population can have no effect on the performance of their health.
Then please explain to me how it is impossible that America's private healthcare system could be made to look bad by the people simply not trying to stay in good health.
Circumcision is an example of Americas problem: time, money, resources, manpower, all wasted on something that does not need to be done if people take care of themselves properly, i.e. wash their penis.
This may sound small, but ~2,000,000 of these unneccessary (in my opinion) operations were performed in 2007, costing $100-200 each. That's, ~$300,000,000 a year.
And then there are the complications, like a narrowed pee-hole (because it's not protected any more) leading to infections and incontinence.
Then there are things like cysts, ulcers, necrosis (tissue-death) of part/all of of the penis, impotence...
All caused by the fact that the surgeon has to guess at how much flesh to remove because he has to guess at how much, and in what way, the penis will change as the child grows.
And because nobody washes their penises properly.
Or, if you're in a tl;dr mood:
It obviously is your fault.
"So, it's defeat for you, is it? Someday I must meet a similar fate..."