Life Expectancy & Health Care Costs
And America's life expectancy is clearly depressed by the life style choices of its citizens, most notably the fact that Americans on average are fatter than any other people.
There are, as I pointed out in a previous post where I discussed the subject at greater length, several specific examples of how these other factors affect life expectancy. For example, Sweden and Denmark have basically the same health care system, yet Sweden is number 10 in the life expectancy ranking while Denmark is 47th. The reason for this is differences in life styles, with for example alcohol and tobacco consumption being a lot higher in Denmark than in Sweden. Similarly, Singapore and Hong Kong have health care systems that are at least as market based as America's, yet they come in at 4th and 6th place. Incidentally, health care spending (at 4% and 5% of GDP) is far lower than not just in America but also Europe and Canada.
A more rational way of estimating health care quality would then be to see how healthy people are given a certain level of initial medical problems (whether caused by genetics, life style choices or other factors). That way you directly control for other factors affecting outcomes. And in this category, America is number one, with for example cancer survival rates being higher than in Europe or Canada and the World Health Organization ranking America number one in the category of responsiveness to health problems.
It should further be noted that these other factors do not simply lower life expectancy, they also increase health care costs. If a lot of people suffer from cancer or are obese, then some of them will die prematurely and so lower statistical life expectancy. At the same time, both these people and those that survive will often require medical attention and so increase health care costs. So, life style choices and the other factors lowering America's life expectancy are at the same time a partial explanation for the high cost level. For that reason, the attempt made by leftists to use life expectancy in relation to health care costs is even more misleading than Mankiw and Becker argued they were.