Wealth inequality is high and rising in the US and other high-income countries, though older adults in the US face a greater wealth-related health disadvantage as compared to their counterparts abroad. In the context of growing wealth inequality, there is an urgent need to better understand the relationship between individuals’ health, wealth, and the cross-country disparity in health system generosity and design. This work aims to understand how health system design can influence the impact of wealth changes on health and of adverse health events on wealth.