From the “Well duh!” files:
Our health care system is the best in the world, so why is it that our mortality rates aren’t as low as we’d expect? It turns out it has very little to do with quality of health care and more to do with (gasp!) personal responsibility:
The health care system could be performing exceptionally well in identifying and administering treatment for various diseases, but a country could still have poor measured health if personal health care practices were unusually deleterious.
So in other words, you can have access to the best health care in the world, but if you choose to continue smoking or eating poorly, well, nothing in the world other than good luck and hearty DNA will help you. At that point, you have no one to blame but yourself.