"What's wrong with a government-provided alternative plan to keep the insurance companies honest and more competitive?"

Elder: Here's a recent example of what happens when government sets up "alternative" plans to cover the uninsured at (supposedly) lower costs. Hawaii offered universal child health care -- for seven months. Then it dropped the plan. Why? People (and employers) with private plans dumped them to ride the "cheaper" government train. One of Hawaii's health care administrators lamented, "I don't believe that was the intent of the program." And Hawaii is a small state, without nearly the number of "health insurance needy" as we have on the mainland.

"Come on! Obviously the American health care system IS broken! That's why our life expectancy is so much lower and our infant mortality rate is so much higher than in other countries."

Elder: Ezekiel Emanuel, a medical adviser to the President (and brother of Rahm, the chief of staff), once told me, "Life expectancy is one of the dumbest ways to measure the quality of a nation's health care." Quality of medical care does not -- by itself -- determine life expectancy. For example, deaths from accidents and murders are much higher in America than in other developed countries. Texas A&M health economist Robert Ohsfeldt and health economics consultant John Schneider calculated that if accidental deaths and homicides during the '80s and '90s were removed from the calculations, life expectancy in America would have ranked at the top of all developed countries. What about personal behavior? Obesity leads to serious health problems, including heart disease. One-third of Americans are obese -- almost 50 percent more than the British and Australians, over 100 percent more than the Canadians and Germans, about 250 percent more than the French and 1,000 percent more than the Japanese.

As for infant mortality, a 2007 study by economists June and David O'Neill found that low birth weight drastically increases an infant's chance of dying. They compared U.S. infant mortality (6.8 per 1,000 births) with Canada's (5.3). Teen mothers are far more likely to have low-weight babies, and America's teen motherhood rate is three times higher than Canada's. They determined that if Canada had America's low-weight birth distribution, Canada's infant mortality rate would rise from 5.3 to 7.06. If America had Canada's low-weight birth distribution, our infant mortality rate would fall from 6.8 to 5.4.

So don't blame the "broken health care system" for lower life expectancies. American health care actually helps us cope with the consequences of unhealthy lifestyles, keeping our ranking from being even lower.