Ask around for the healthiest country in the world, and the United States won't come close to topping the list. People live longer in just about every industrialized nation, from Canada to our north, throughout much of Europe, and around the Pacific in Japan, Australia and New Zealand. New mothers and their babies also face a rockier start here, with U.S. infant and maternal death rates double some of our industrialized peers. As debate swirls in Washington and at town halls nationwide over health care reform, there is also a more fundamental question - what about health? If you want to see dramatic changes in health, you're not going to get there even by doubling the efficiency and effectiveness of the health care system," said Dr. Richard Kravitz, a University of California, Davis, professor of medicine whose research interests include quality of care. "When you need it, you really need it … but in general, the benefits of medical care to populations are a little bit overrated," he said. When taken all together, the other factors that play a bigger role include education, income, toxins in the environment, crime, violence, family structure, stress, obesity, nutritious food and exercise. Across large populations, he said, numerous studies suggest that medical care contributes only modestly to overall health, perhaps somewhere between 10 percent and 25 percent. Health care for all would provide a "very large" improvement for some deprived populations, Kravitz said, but "a surtax on high fructose corn syrup would probably be more effective ... than anything we could do for the health care system, just because of obesity."