AMERICA remains the world’s most profligate spender on health care, according to a report published on November 4th by the OECD, a club of 34 mostly rich countries. In 2013 the United States spent, on average, $8,713 per person—two and a half times as much as the OECD average. Yet the average American dies 1.7 years earlier than the average OECD citizen. This longevity gap has grown by a year since 2003. Americans have the same life expectancy as Chileans, even though Chile spends less than a fifth of what America spends on health care per person.