Critics of the American health care system who compare life expectancies are comparing apples and oranges. Of the industrialized countries with better life expectancies than the U.S., nearly all have overwhelmingly white populations of European descent. None have large black populations. The American population is a mixture of several ethnic groups - some with longer and some with shorter life spans than whites. Pointing to the average distorts the picture significantly.
Critics claim that the second-best indicator of the quality of health care is infant mortality.
However, the evidence shows that differences in infant mortality frequently reflect differences in genes, lifestyles and environments rather than in the quality of medical care. Data from the California Department of Health Services, for example, show that the average infant mortality rate was 8.6 deaths per 1,000 live births in the 1980s. Since individuals in the different groups often live in the same communities and use the same hospitals and physicians, the difference clearly is a result of something more than the health care system. The health care policy problem is that some ethnic, geographic and economic groups need better health care. Desegregating the numbers helps illuminate the target populations to whom better health care must be delivered.