Every few weeks, Twitter kicks around U.S. versus European material living standards, and I’m mostly Team America1 on this.

But this only makes it more striking that Americans have markedly worse health outcomes and life expectancies than residents of Western Europe or rich Asian countries. Indeed, life expectancy in the United States is so bad that the relevant comparison class is a set of much poorer countries like Chile and Poland — countries that are richer than the world average but aren’t even close to the top.

A common left-wing knee-jerk reaction is that this reflects deficiencies of the American healthcare system, but I think that’s mostly wrong.

Despite the shortcomings of the U.S. safety net, the vast majority of people do have health insurance, and America’s track record at disease-curing is actually quite good. But more broadly, “health care” as we understand it is a relatively weak lever for improving life expectancy. Historically the big gains have come from public hea…