[jammur]

It was definitely a dig, but I don't think he was seriously implying the US isn't a first world country. I think the frustration stems from the fact that the US is the most obvious example of a first world country, and yet still hasn't figured out how to provide cost-effective and universally available healthcare to its citizens.

[sjtgraham]

yes, hence "disingenuous".

[jacalata]

I'd go with 'sarcastic' myself - I assume he is not attempting to mislead anyone or to pretend that he sincerely believes it.