By what measure is our healthcare the least effective?  Our AIDS and Cancer survival rates lead the world.    According to the World Health Organizaiton Cardio Vascular Disease kills the most people, almost 18-million per year worldwide.  Age-standardized mortality rates for CVD are in excess of 500 per 100,000 in Russia and Egypt; between 400 and 450 for South Africa, India and Saudi Arabia; and around 300 for Brazil and China. This is in contrast to rates of between 100 and 200 per 100,000 for Australia, Japan, France, and the United States.  WHO notes "Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies."   Lifestyle, rather than the kind of health care system one has appears to have more impact on the world's biggest killer.  Reports from single payer adcovates say otherwise.  I prefer facts.