Life expectancy is dropping in the United States, despite the nation spending more per person on health care than any other country. So what is a place like Portugal — where people live longer with far fewer resources — doing right? And what is the United States missing?

Today on “Post Reports,” we bring you a tale of two sisters, two countries and two health systems. 

Lurdes and Lucilia Costa share a lot in common. They’re sisters, and they both have rheumatoid arthritis, a complex chronic illness that requires special medical attention to prevent worsening symptoms. But their health care experiences couldn’t be more different, with one living in Portugal and the other in the United States. 

For The Post’s Frances Stead Sellers and her colleague Catarina Fernandes Martins, these sisters’ divergent paths contain larger lessons for why a country with lots of resources, such as the United States, is floundering at keeping people alive — while Portugal, a small country that spends much less on health care, is doing so much better promoting longer, healthier lives. 

“Portugal is one of the countries that people describe as positive outliers,” Sellers told “Post Reports.” “They’re living longer than we are, and a key thing there appears to be primary care and community health. They’re really looking after people before they get to hospital.”

Read more:

A tale of two sisters, two countries and their health systems 

Compare your life expectancy with others around the world

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