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PhilGoetz comments on So you say you're an altruist... - Less Wrong
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Yep, there is definitely a difference between killing and not saving. However, I think a reasonable definition of an asshole is someone whose coefficient modifying the experiences of others in their decision-making is below some threshold. (An example of how to compute the coefficient: Let's say I want a car. If n is the number of people like me such that I would be indifferent between giving a car to all those people and giving a car to myself, then my coefficient is 1/n.) So it's possible to be an asshole without breaking any specific moral rules.
Also, presumably in a society where you lived a very long time, problems like starvation, AIDS, and malaria would have been solved.
If you gave everyone in the world a car except me, my standard of living would go down dramatically. I'm not just indifferent to that; I see it as negative utility. So on your scale I am infinitely assholic.