Demographics has a big impact on life expectancies. Asian Americans have a life expectancy of 84 years for instance. Which is better than Portugal by 3 years. Comparing life expectancies on a per country basis is fraught with error if attempting to attribute differences to health systems. Genetics, climate, diet — all have huge impacts on life expectancy.

Puerto Rico has a life expectancy of over 82 years and has the same system as the U.S. It’s a year higher than Cuba in fact. Why does Puerto Rico do better than Cuba when the Cuban system is often claimed to have a better health system? Puerto Rico also has a higher life expectancy than Portugal.