In my bachelor days I lived for years without a car, relying on walking, biking, and public transportation. But that was also in the Portland, Oregon area, where the roads and the rails and the weather make that easier than almost anywhere else in the USA. Now, trying to support the expanding horizons of a teenager etc., in a much less hospitable environment - certainly it would still be possible to live without a car, but at a much greater cost.
The automobile can stand as the common denominator between two of our major long term crises, health care and climate change.
The health care crisis is extremely complex, of course. It is clearly not sustainable to have health care costs as a growing fraction of the GDP. And the services provided don't seem to be optimally distributed - certainly many people are under served. It may seem harsh to suggest that some people might be over served, but it does seem that we need to look carefully at what we expect from the health care system. Old age, sickness, and death can be managed to some extent, but not utterly evaded. A desperate grasping at some ideal of physical health, is not healthy at a more meaningful level.
Another difficult component of the health care crisis is preventative medicine, or really just healthy living practices - diet and exercise being the cornerstones. The simplest way to manage these is to incorporate healthy eating and movement as an integral dimension of one's life, rather than as some separate health care activities. A great way to get exercise is to walk to the grocery store and then carry one's groceries back home. But there needs to be a grocery store within walking distance!
One can always choose where to live with grocery store proximity as a highly ranked criterion. But there are many other important criteria, such as proximity of one's job and family, cost and availability of housing, etc.
In a way it seems so simple - if we just rearranged our culture so that all the facilities one needed in regular daily life were accessible by foot or bike, we could make huge dents in both the health care crisis and the climate crisis. But our culture is such a complex system, with so many interlocking components each holding the others in place, so that nothing can change very much without everything else changing too - the problem seems insurmountable.
Of course this is always the nature of things - liberation has always been right in the palm of our hand, yet how many of us manage to find our way clear of this vicious cycle of suffering and confusion. And yet, if we just tap our courage, keep our goal in mind and boldly take the steps at our feet, miracles do happen!