Do countries like Cuba and America calculate life expectancy the same way? If the US makes heroic efforts to save a “misborn” baby who lives for a few days and Cuba just lets them die and considers them miscarriages, for example, that could shift life expectancy.
Good intuition! Yes, different countries calculate Life Expectancy in different ways, infant deaths having particularly disparate methodologies. This makes "macro" variables like Infant Mortality and Life Expectancy "problematic" when comparing countries. That said, there's also demographic factors that cloud the stats - Americans drive more, and die more on the road, for example. Take out Violent Deaths (accidents, suicides, murders) and the USA has the 2nd highest Life Expectancy on Earth, just behind Japan.
When comparing Health Systems, economists (when not trying to "prove" a point) look at OUTCOMES - a slightly dated example (about a decade old) on Prostate Cancer - 5 year post-diagnosis Mortality: If you found out on January 1, 2010, that 200 ASIF lurkers JUST found out they had Prostate Cancer, 100 in the UK, 100 in the USA, by January 1, 2015 you could expect to hear of 27 funerals due to the cancer in the UK ... versus 3 in the USA.
The cost ... ahhh the cost. Truly out of control in the USA ... BUT ... health insurance is the culprit, primarily, and its purchase PRE-TAXATION is a big part of it. Austrian-style analysis serves well here (just as it did during past and current Housing Bubbles): Prices equilibrate to the "leverage" provided by income tax rates just as they do to interest rates - prices are set "on the margin."
If one were to make, say, automobiles fully tax-deductible, one would expect prices to rise commensurately, and one would not be disappointed when they did - other than to shake one's head yet again on how government policies distort markets and create Deadweight Losses. Most healthcare is PALLIATIVE, not critical, life-saving stuff. Not to be "uncaring," but to an economist, a hip replacement and a new BMW are both simply purchases that improve quality of life.
The whole thing's a mess. Imagine "we" had health-style insurance on an even greater necessity than healthcare - FOOD. All your groceries and meals, tax deductible. Think it would shift the quality mix and quantity (in dollars) of food purchases? Of course it would. Imagine paying 20% "copay" on steak dinners - $200 at Ruth's Chris, but only $40 to me. Hell yes I'll have the creamed spinach, and bring us another bottle of wine.
Of course, if we did this today, overnight, the line at RC would be around the block the next day. Supply wouldn't match demand until ... prices were hiked. And that, in a nutshell, is the story of the United States' high health spending. Good or bad, that's normative and not in the economist's purview, strictly speaking. Imagine yourself in need of emergency surgery, tho ... where do you want to be: New York or Havana...? 2 cents worth, over and out....