Saturday, September 12, 2009

Health care: US vs the World

David Friedman looks at claims about how health care in the US ranks against other nations.

In the course of the healthcare debate, supporters of change along the lines proposed by the administration have called attention to a World Health Organization study ranking the health care systems of 192 nations. A common claim is that the U.S., despite spending more per capita than any other country, still ranks only 37, behind most developed countries.

That version of the claim is at best misleading. There is a measure, "Overall Health System Performance," on which the U.S. ranks 37. But it is a measure that takes expenditure into account, downrating the U.S. precisely because it spends so much. The rank is 37 not in spite of the level of expenditure but because of it.

There is another measure, "Overall Goal Attainment," which does not take account of expenditure; on that the U.S. ranks 15, still behind a fair number of other countries but not nearly as many. So a more accurate claim would be that the U.S. ranks 15 despite its large expenditures.
My conclusion is that the numbers produced by the report are very nearly useless for purposes other than propaganda, since they do not provide much information on how good the health care systems of different countries are at delivering health care.

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