Some want luxuries like insulin.

Sure, what's your point though? How much % do you donate out of your salary to fix global poverty?

Because context is hard, I guess, my point is that "exiting the rat race" is generally something that only people with Mountain View addresses and opinions like "400k TC really isn't THAT much, if you think about it" tend to be able to do.

Sure. And they have to accept the consequences of considering that a need.