For ordinary middle or upper middle class families, health care and housing are two major expenditures in living. Of course, if you decide to have children (nowadays not everyone wants to) that is a third source of major expenditure. However, children do grow up, leave home, and become independent. The first two classes of expenditure stay with you till you pass. So, what are the considerations for persons like myself and my wife living in the greater Boston area (or similar areas such such as Bay area in California or other metropoltan centers of the nation). 

Let us talk about health care first. Boston is well known for its famous Hospitals, such as Mass General Brigham. Important people all over the world come here for difficult diagnosis ans treatments by world famous doctors and surgeons. But Mass General is old, parkings are expensive and difficult. On the other hand, suburban and much newer hospital unit such as Lahey that sprung up in the past couple of decades are equiped and organized according to the latest advance in medical technology. They are more often staffed by medical personnel not trained in US but immigrated to the US. Not being as famous, they compete harder and more accomodating. You don't have to wait months for appointment. And for routine treatments, one receives more efficient care with more modern equipments and procedures. As one gets older and with reasonable health, we actually opted for the latter kind of doctors and treatments because of convenience - no more than 15 minutes away for quicker treatment and with plenty of parking. This is a tradeoff we made a few years back that we have not regreted so far.

Next, let us consider buying vs renting your residencial housing. Real estate, particularly your home, was and still is a most profitable investment for ordinary middle class people (our only home increase in value approx. 10 times in 56 years). Many tax advantages and laws exist to encourage buying your own home. On the other hand, renting offer flexibility and less maintainence tasks and stresses. American economic environment and job opprotunities also mean that a family move several times in as many decades,years, and careers. For young people starting out, renting may be the only option. Most  couples and families including ourselves have gone through such economic considerations and tradeoffs. In a career of 60+ years we have gone from renter, to home owner, and back to senior community living. 

So here we are after 74+ years of living and surviving in the US starting from scratch and nothing - this is living the American Dream!.