Comment by jcranmer

There is a cost to having multiple language-level types that represent the exact same set of values, as C has (and is really noticeable in C++). Rust made an early, fairly explicit decision that a) usize is a distinct fundamental type from the other types, and not merely a target-specific typedef, and b) not to introduce more types for things like uindex or uaddr or uptr, which are the same as usize on nearly every platform.

Rust worded in its initial guarantee that usize was sufficient to roundtrip a pointer (making it effectively uptr), and there remains concern among several of the maintainers about breaking that guarantee, despite the fact that people on the only target that would be affected basically saying they'd rather see that guarantee broken. Sort of the more fundamental problem is that many crates are perfectly happy opting out of compiling for weirder platform--I've designed some stuff that relies on 64-bit system properties, and I'd rather like to have the ability to say "no compile for you on platform where usize-is-not-u64" and get impl From<usize> for u64 and impl From<u64> for usize. If you've got something like that, it also provides a neat way to say "I don't want to opt out of [or into] compiling for usize≠uptr" and keeping backwards compatibility.

If you want to see some long, gory debates on the topic, https://internals.rust-lang.org/t/pre-rfc-usize-is-not-size-... is a good starting point.