A letter in the Wichita Eagle written by Brad Beachy of Wichita makes the case for “so-called socialized medicine” to be brought to the United States. Part of Beachy’s argument relies on a ranking produced by the World Health Organization. That ranking has a number of problems.
The ranking Beachy refers to was produced in 2000, and hasn’t been updated since then. So it’s getting a little old. Worse than that, it contains a number of techniques and biases that work against countries that rely on markets instead of government to provide health care.
A recent paper from the Cato Institute provides some useful analysis of the World Health Organization rankings. (See WHO’s Fooling Who? The World Health Organization’s Problematic Ranking of Health Care Systems)
For example, there are two sets of rankings. As the Cato report explains: “One ranking claims to measure “overall attainment” (OA) while another claims to measure “overall performance” (OP). These two indices are constructed from the same underlying data, but the OP index is adjusted to reflect a country’s performance relative to how well it theoretically could have performed.”
Using the OP rankings, the United States is number 37. But using the OA rankings, the United States is 15.
25% of a country’s ranking is based on “financial fairness,” which is determined by looking at the “dispersion in the percentage of household income spent on health care.” As the reports says “The FF factor is not an objective measure of health attainment, but rather reflects a value judgment that rich people should pay more for health care, even if they consume the same amount.”
The report notes this introduces a bias against countries that rely on market mechanisms for paying for health care.
There’s another problem with FF, too: “Put more simply, the FF penalizes a country because some households are especially likely to become impoverished from health costs—but it also penalizes a country because some households are especially unlikely to become impoverished from health costs. In short, the FF factor can cause a country’s rank to suffer because of desirable outcomes.”
The Cato study goes on to document additional problems with the WHO ranking. Problems with the rankings were noticed earlier, too. An earlier analysis of this report from Cato (We’re Number 37 in Health Care! concluded this:
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Overall, the WHO rankings’ mathematical formulations serve only to distract attention from the authors’ underlying distaste for individual choice in health care. The report largely ignores the extraordinary benefits the American marketplace brings to health care worldwide, such as new drugs, advanced diagnostic instruments such as MRIs and CAT scans, and lifesaving therapies for cancer and heart-disease patients. Under a WHO-style health care system, lifesaving research and innovation would be stifled and individual choice would be discarded in favor of collective control. Bureaucrats would decide who receives care — and who does not — on the basis of statistical tallies that devalue the lives of the elderly, the disabled and the chronically ill.
By contrast, a free-market health care system upholds the right of every person to make his own decisions. Patients are given choices, not issued numbers, and doctors are freed from impersonal “expert panels” dictating what care they can and cannot provide. The WHO’s idea of government-provided universal health care is a fantasy that masks a system of dangerous, formula-based rationing. If you value your health, don’t trust the WHO.