While Americans may have a lower life expectancy than other affluent countries, the disparity is mainly due to Americans' poor personal health-care practices -- not to any flaw in health-care treatment. "The U.S. actually does a pretty good job of identifying and treating the major diseases. The international comparisons don't show we're in dire straits," says University of Pennsylvania's Dr. Samuel Preston, a researcher who has studied the matter.

The real problem, it turns out, is that Americans are accident-prone, health unconscious slobs. Until the mid-1980s, the U.S. had the highest per capita cigarette consumption in the developed world, and the U.S.'s obesity rate today is more than twice that of Canada and ten times that of Japan. These aren't problems of the health care system (i.e. in the diagnosis and treatment of disease). These are problems of behavior. Adjust that data for the higher U.S. incidence of homicide and obesity, and Americans actually have the highest life expectancy in the developed world.

The reasons that we do not have the highest life expectancy in the world are self-inflicted. We smoke too much, eat too much, eat the wrong things and lead a stressful life. These are not things that the health care system can control.

On the other hand, all the maladies caused by these self-inflicted wounds are expensive to treat: cancer, heart attacks, diabetes, etc. This is one reason we spend more than other countries.