Kurt Ullman wrote:

The problem with America's figures is that they lay a lot of the blame
for social issues on the medical system. There is a pretty fair
correlation between number of teen pregnancies (and single mother
households) and extremely low birth weight babies. In turn there is a
relationship between low birth weight and infant survival. We lead the
league in that respect largely for social reasons and not medical
reasons. Even among developed countries, those with high teen preg
rates also have worse infant mortality.
Another sidelite with infant mortality is that many developed
countries don't even count babies below a certain weight as live
births. We do. And we try to save them.
Life expectancy also has societal implications. Every teenager
that dies in a drive by or from drugs or just piles his car into a
tree lowers the life expectancy much more than keeping a geezer alive
between 70 and 80.
Indeed there are some rather interesting indications that if it
wasn't for the medical system our figures in both these areas would be
even worse. We put most low birth weight babies into ICUs and fight
like hell to save them.. and do a fair %age of the time. There are
indications that our trauma systems may be saving more of the victims
of drive bys as shown by a decrease in the murder rate but no changes
in the shooting rate (thus turning murder investigations into
attempted murder investigations).
These are not as cut and dried as many would have us beleive.

Right. Many offer various proxies for the success of a country's medical
system. The most often used are cost and life expectancy.

* COST - Americans do spend more for health care than countries X, Y, and Z.
Guess what? We spend more because we CAN. America is a rich nation and we
elect to spend some of those riches on health care.

* LIFE EXPECTANCY - As you mentioned, we have several factors influencing
life expectancy not found in many other countries: Gang shootings,
automobile accidents, premature babies, executions via a valid warrant,
Dancing With The Stars, and more.

A MUCH better metric for determining the efficacy of the health care system
is life expectancy AFTER diagnosis. In almost all areas, breast cancer,
congestive heart failure, blah-blah-blah, the US leads the world, sometimes
dramatically. For example, the five-year survival rate for breast cancer is
84% in the US and 70% in the UK. I think the US is #2, behind Canada, in one
particular form of cancer - I forget.