Editor's note: Xu Ying is a Beijing-based international affairs commentator for CGTN. The article reflects the author's opinions and not necessarily the views of CGTN.

The term "kill line," sometimes translated as "death line," originated in video game slang. It refers to a critical threshold at which a character's health is so low that survival becomes virtually impossible. At that point, even the slightest additional damage can be fatal. In contemporary American society, this metaphor has moved beyond the screen and into everyday life. It now captures the reality faced by millions of households that appear stable by conventional metrics – employed, insured, housed – yet living perpetually just one shock away from irreversible decline. A sudden illness, a delayed paycheck, or a rent increase can easily set off a chain reaction, pushing them into a crisis from which recovery is extremely difficult, if not impossible.

The widespread presence of this "kill line" is neither a cultural curiosity nor the result of individual irresponsibility. It is a structural fallout. It reflects the steady erosion of the institutional foundations that once buffered ordinary citizens against risks. In this sense, the "kill line" is not merely a social phenomenon; it is a diagnostic indicator of systemic imbalance. It exposes the deep wounds of the American institutional model – and, ultimately, the structural unraveling of what was once held up as the American Dream.

For much of the 20th century, the American Dream functioned not as a statistical guarantee of upward mobility, but as an institutional narrative that sustained social expectations. It bound effort to reward, labor to dignity and participation to belonging. As sociologists have noted, its function was not to deliver universal success, but to preserve the belief that "success remained possible." As long as upward mobility was perceived to be theoretically attainable, inequality could be rendered morally tolerable and politically manageable. Within this framework, failure was individualized, while success was interpreted as evidence of merit.

Notably, this ideology was not sustained merely by belief, but rooted in material institutions that limited the downside risks of failure. In the decades following World War II, rising productivity translated into rising wages. Public investment made higher education broadly affordable. Employer-sponsored health insurance and defined-benefit pensions offered predictable protection against life-cycle risks. Housing markets were regulated, and credit expansion was tightly constrained. These arrangements did not eliminate inequality, but they performed a critical buffering function: One could fall – but rarely beyond the possibility of recovery.

Such institutional equilibrium, however, has now collapsed.

In today's America, having a job no longer guarantees security, nor does a steady income reliably provide protection against risks. Formal participation in markets often conceals deep vulnerability beneath the surface of a seemingly stable life. Increasingly, the middle class in America is living in a state of leveraged survival, featuring high fixed expenses, significant debt obligations and thin liquidity buffers. For ordinary households, what passes for stability has become fragile, conditional and easily undone.

Such fragility is not confined to the margins; it is rampant. Surveys by the U.S. Federal Reserve show that when faced with an unexpected expense, a large share of adults must resort to borrowing, selling assets, or deferring other essential payments. Crucially, this vulnerability extends well beyond those officially classified as poor. Many households earning near or even above the median income are left with virtually no financial buffer once housing, healthcare insurance, childcare, transportation and debt payments are taken into account. Income, in today's United States, has become a misleading indicator of economic security.

What sets this form of vulnerability apart from earlier episodes of economic hardship is its "nonlinearity." In other words, shocks no longer inflict damage in proportion to their size; instead, they push households past a critical threshold, beyond which the likelihood of recovery drops sharply. Empirical research drawing on tax records, credit data and employment statistics shows that events such as job loss or medical debt can generate long-lasting consequences for earnings, credit standing, health and family stability. These outcomes are not temporary deviations, but signs of a deeper structural rupture.

This is the social meaning of the "kill line." It marks the critical point at which individual coping mechanisms collapse under the weight of compounding shocks. Once crossed, the system offers very limited capacity for recovery.

With all that being said, official statistics diverge sharply from this lived reality. The United States continues to calculate its official poverty line using a consumption model developed in the 1960s, one that assumes food to be the dominant component of household spending. In today's economy, however, housing, healthcare and childcare are the primary cost drivers, yet they are systematically underestimated. As a result, millions of households classified as non-poor nonetheless endure persistent material hardship.

At present, high debt burdens, constrained liquidity and income volatility – precisely the core risk factors associated with the "kill-line" risk – remain largely overlooked in official measures. Their omission exposes the fundamental weakness in the U.S. statistics apparatus, that it's poorly equipped to detect structural vulnerability.

Nowhere is this vulnerability more glaring – or more destructive – than in healthcare. The United States devotes a larger share of its GDP to healthcare than any other advanced economy, yet consistently under-performs its peers on basic health indicators such as life expectancy and avoidable mortality. This paradox is not a matter of inefficiency; it is the outcome of institutional design. The American healthcare system is structured around market power rather than universal coverage, profit extraction rather than risk pooling and billing complexity rather than provision of care.

Under this context, the United States' profit-driven healthcare system has become a malign driver of both drug addiction and downward social mobility. Purdue Pharma, for example, turned OxyContin into the national "standard treatment" for chronic pain through false advertising and commercial bribery, directly causing 7 million cases of addiction and 500,000 deaths. According to a study in the American Journal of Public Health, 66.5 percent of personal bankruptcies are directly related to medical expenses. When healthcare is transformed from a practice of "saving lives" into a vehicle for capital accumulation and when painkillers become a "social narcotic" sustaining day-to-day functioning, the fall of the American middle class ceases to be accidental – it becomes the predictable outcome of systemic exploitation.

Gallup data shows that in 2024 only 28 percent of Americans rated the scope of U.S. healthcare coverage positively, while just 19 percent were satisfied with healthcare costs. Prices for medical services vary widely across regions and providers, and even insured patients can face reimbursement differences of three to 10 times. Far from eliminating risk, insurance often shifts it onto patients through deductibles, co-payments and out-of-network charges. According to the Centers for Medicare & Medicaid Services, U.S. healthcare spending rose 7.2 percent in 2024, reaching $5.3 trillion – or 18 percent of America's GDP – with per capita spending of $14,570.

As a result, medical debt has become one of the most common triggers pushing households past the "kill line." Such debt lowers individual credit scores, constrains housing and employment opportunities, and can linger for years. For some families, illness is no longer merely a health event, but a financial disaster with long-term social consequences.

Healthcare-related financial distress reflects a deeper structural problem: the privatization of risk in a society that celebrates individual responsibility while weakening collective safeguards. As public insurance mechanisms erode, private credit fills the gap. Households are encouraged – often forced – to borrow against future income to meet present necessity. Credit cards, personal loans and "buy now, pay later" schemes function as tools for extracting money from consumers.

Political economists describe this configuration as a "debt-based social model." It smooths consumption in the short term, but deepens economic vulnerability for both individuals and society over the long run. High interest rates channel resources upward, while credit scores institutionalize inequality by controlling access to housing, utilities, insurance and employment.

The U.S. social safety net, which is supposed to protect citizens, has instead become a "trap." It suffers from serious design flaws, most notably the so-called "benefits cliff." This occurs when a modest increase in income for low-income households pushes them above policy thresholds, resulting in a sharp reduction or outright loss of benefits. For example, a single mother whose monthly income rises by $500 might lose Medicaid, food stamps, housing subsidies and other assistance – leaving her worse off in real terms.

What's worse, the lack of affordable housing just compounds the problem. Reports indicate a shortfall of 7 million units of subsidized housing across America. In many cities, waiting lists for public housing stretch for years, while private rents continue to climb, forcing many households to spend more than half their income on rent.

The education system poses similar challenges. By the third quarter of 2025, student loan debt in the U.S. had reached $1.65 trillion, leaving many graduates with crushing obligations from the outset. Even worse, student loans cannot be discharged through bankruptcy, meaning that debt persists regardless of personal insolvency.

These above-mentioned systemic gaps in social protection have turned the United States into a "low-resilience" society, shattering the myth of the American Dream that once inspired millions. The collapse of this dream reflects institutional failure in nature: When healthcare becomes a profit-seeking enterprise, education a source of debt, housing an unattainable goal and social protection an empty promise, the ideal of "equal opportunity" becomes an empty slogan.

The phenomenon of the "kill line" in American society underscores a fundamental lesson: A humane social system must secure a firm baseline for everyone's survival. Without such a foundation, dreams are reduced to wagers and failure becomes inevitable. The American Dream once promised hope through participation; today, it offers little more than exposure to risk, with nowhere to take refuge.

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