Problems with using [the commonly-cited] LE statistics to gauge the quality of health care systems:

- They don’t exclude factors that are exogenous to health care (murders, auto fatalities, suicides, deaths from diseases that can’t be prevented and/or for which there are no known treatments, etc.);

- They don’t exclude (or at least make allowances for) deaths from medical conditions that are entirely the result of personal behavioral choices (obesity-related, smoking-related, drinking-related, and other behavior-related health conditions);

- The cause of death listed on death certificates is not reflective of the different factors that might have led to the death (a person who is healthy prior to getting into an auto accident and then develops chronic health conditions that eventually result in that person’s death is not likely to have his cause of death be listed as a car accident, even though that is the ultimate cause of death);

- Deaths from factors that appear to be exogenous to health care might, in fact, be a result of the the health care system (how many auto fatalities are the result of poor distribution of emergency services (on the flip side, how many are the result of poor highway and road planning));

- They don’t account for the cultural differences that lead to different rates of deaths for different causes (the US’s higher teen pregnancy rate, which leads to all kinds of bad consequences; the increased reliance upon automobiles instead of public transportation, which leads to all kinds of bad consequences; the US’s historically-higher [than European nations'] smoking rate (which has reversed over the decades), which didn’t really begin to manifest itself until the latter half of the 20th century (most people before the latter half of the 20th century didn’t live long enough for many cancers and other health conditions to become a problem (Alzheimer’s is becoming a more serious problem now for the same reason)); Americans’ increased exposure to plastics, pesticides, steroids (via meats), pharmaceutical drugs; the effects of racism and sexism);

- They don’t account for the problems generated by the huge influx of immigrants from third-world countries (who bring with them all kinds of problems that lead to earlier deaths for themselves and their children).

There are all kinds of problems – in addition to those listed above – with using LE statistics to gauge the quality of health care systems. Unfortunately, people keep simply keep repeating the same Michael Moore talking points because they know full-well that most people probably don’t have the slightest clue (or don’t care) about how statistics can be manipulated to fit an agenda.

While researching, I did come across a couple studies (one of which was this one: http://www.bmj.com/cgi/content/full/327/7424/1129) that do take a stab at calculating life expectancies without the factors that are exogenous to health care included in the calculations so that a more accurate picture of the quality of different health care systems could be seen. What they found was that the life expectancy rankings of some countries changed dramatically while others only changed slightly. While these LE statistics are far better than the general ones that are used, they’re still very problematic (and the authors of the studies admit that) because of the many problems associated with determining why people died.

All-in-all, I don’t expect these kinds of studies to have any impact on anything. Few people care and fewer people who have the means to make things happen want to see the government removed from the health care system.