Lack of health insurance is one factor contributing to poorer health, especially among the poor. Life expectancy in the United States is 78 years, lower than Japan's 83 years, or Australia's or Israel's 82 years. According to the World Bank, in 2009 the United States ranked fortieth overall, just below Cuba.54 Infant and maternal mortality in the United States is little better than in some developing countries; for infant mortality, it is worse than Cuba, Belarus, and Malaysia, to name a few.55 And these poor health indicators are largely a reflection of the dismal statistics for America's poor. For instance, America's poor have a life expectancy that is almost 10 percent lower than that of those at the top.56 We