I too grew up in Appalachia and quite poor ($6000 / year for a family of 5), and aside from the camaraderie of poorness, I wouldn't want to inflict that hardship on anyone: few jobs, poor food, poor housing, poor schools, poor hospitals, poor infrastructure.
Where I grew up there were two classes of people: the 'professional class' and the 'working class'. The professional class were multi-generational groups of irresponsible doctors, preying lawyers, slum lords, land owners, government cronies, and other sorts of con men. Their spouses, children, and cousins took most of the other middle class occupations. The rest of us were left with the scraps of broken 100 year economies of iron, coal, and steel. And, these two group rarely mingled.
When people ask me what it was like to live in Appalachia in the 80s and 90s, I tell them to rent Gummo http://www.imdb.com/title/tt0119237/.
Would you mind expanding on that?
My wife's grandmother was on the decline due to dementia. Her care requirements were so high that we had to put her into a care facility. The problem is, because her symptoms didn't require putting her into a $6k a month facility, insurance wouldn't cover it. So for the remaining year of her life, we had to come up with the $4.5k a month for her care.
The care for people here is expensive, so much so that it can destroy families.
> the doctors were so horrible they couldn't even begin to figure out what was wrong with her
That happens here too, unless you have the ability to pay for a trip to the Mayo clinic.
> the local hospital had no MRI or CT machines
Ours does, and the costs for using it are prohibitive if you have no insurance. In fact if you have no insurance, you aren't welcome at the hospital unless you have a life threatening problem, like actively bleeding out.
> I personally grew up in one of the poorest parts of America, Appalachia.
That doesn't describe even my hometown, a relatively rich corner of Montana with lots of disposable income coming in from California expats. We have homeless, folks who can't afford a car, a few murders a year... in a town with a population around 40k.
Yeah, unfortunately a lot of our good doctors are swept by the offers made by the western countries. It's sad, but true.
I think you're completely off base, and obviously so. Americans have among the highest disposable incomes on earth, falling household to income debt levels, and a jobs picture that has been improving non-stop for five years. Americans also have among the highest median household net wealth levels of any nation, and the best universities by far. Bulgaria? That claim almost comes across more as propaganda, when you understand that even Romanians look down upon the poverty in Bulgaria.
I personally grew up in one of the poorest parts of America, Appalachia. My experience is the exact opposite of what you describe. Where I lived there were no homeless; wages were half the national average, and we had great public schools, with some of the best rated teachers in the state; everyone had a home, and a car; a nearly zero murder rate; the standard of living was on par with the US median because the cost of living was very low; unemployment was higher, and people lived relatively simple lives when it comes to materialism. This is all mostly still true there today. Compared to the childhood of real poverty my Romanian friend endured growing up there in the 1990s, I grew up in paradise. Where I grew up, the poor there today have access to medical care and routine medical tech via medicaid, which the median household in her Romanian city can't get access to without going to Bucharest.
But don't take my word for it -
OECD better life index:
http://cdn.dejanseo.com.au/wp-content/uploads/2012/02/better...
And
http://media.economist.com/sites/default/files/imagecache/fu...
You could also run a dozen other economic metrics like long-term unemployed, unemployment rate, median income, median household net worth, household debt to income, health outcomes from medical care, access to the latest medical technology and drugs. You could compare classic markers for materialism for the poverty line and what it's defined by in say the US vs Bulgaria. The US does extremely well in most comparisons. There are perhaps eight countries on earth that produce better quality of life outcomes than the US, and for the top 75% maybe only five countries do better.