Overall Health: This is actually two measures—one of average health and one of “distribution”, which is statspeak for “fairness”.  The two numbers are similar enough to be the same and I’m really not sure what he point of “distribution” is.  Healthy people aren’t living to be 300 and having 87 healthy babies to skew the numbers that badly.

The rating is mainly based on lifespan and infant mortality.  By these measures, the United States ranks 22nd worldwide.

22nd is nothing to be proud of, but there are number of problems with taking this ranking as a measure of our healthcare system.  For one thing the United States is the most obese nation on Earth.  The Health Nazis are constantly telling us this is killing hundreds of thousands of people a year. The WHO does not account for this. Nor does it account for the US being the most violent nation in its peer group, as Michael Moore would be the first to tell you. 

I’m not 100% sure based on my reading of WHO’s methodology, but they also appear not to account for the US system going to heroic lengths to save extremely premature babies who are simply listed as “stillborn” in other nations.  This has a tendency to skew both our infant mortality and lifespan numbers.

Responsiveness: This is a measure of how easy it is to get a doctor, a procedure or surgery.  How quickly the healthcare system will treat you when you get sick.

The United States ranks #1.  I repeat, the United States has the most responsive healthcare system in the world, according to WHO.  By comparison, idyllic France ranks 16th.  Perfect Canada ranks 7th.  And the little island paradise Michael Moore visited?

115th. (Damn those Cubans thinking for themselves!)

Responsiveness actually tracks extremely well with the customer satisfaction measured in other surveys (in which the US ranks #1 by a long shot as well).  So whatever Michael Moore may think of our healthcare system, we appear to be happy with it.

Fairness in Financial Contribution. This is the key to understanding the WHO rankings.  The United States ranks 54th in this dubious category.  Fairness essentially measures the skew of healthcare expenditures.  And we find that, low and behold, the very sick in this country tend to rack up a lot of bills.  If our system were socialized, the burden would be distributed more “fairly” and ranking would be higher.

The thing is, even you Moore-ons out there will have to admit that this statistic is unfair to the United States, no matter what you think of fairness or socialized medicine.  To illustrate why, let me return to the aforementioned premature babies.  An extremely premature baby can rack up $200,000 in medical bills.  This is obviously far greater than the average $6,000 each American spends and will skew the numbers.  Of course, insurance will pay that for most Americans.  And the others, at worst, will go bankrupt and the hospital will write it off.  Of course, we’d have more in the former category if it were possible to buy cheap “disasater scenario” health insurance, but I digress.

A massive skew is the natural result of having an innovative healthcare system.  The United States invests enormous amounts of time and treasure into developing cutting edge technology—procedures and drugs that start out being extraordinarily expensive but eventually become cheaper and find their way into the socialized nations of the world.  It is a simple fact that the pioneers who are the first to try advanced anti-retrovirals, artificial hearts and stem cell transplants will also rack up gigantic bills when they do so.

And while one could argue that maybe the government should pick up the tab for experimental procedures, I’m extremely loathe to have a bunch of lawyers deciding what experimental procedures should and should not be done.

If we want to improve the “fairness” of our financial burden, we should just let these people die.  As I like to say—dying is always cheap.  And in a socialized medical system, that’s almost certainly what would happen.

In any case, you can now see why I don’t like the WHO’s ranking of the US being used as an argument for socialized medicine.  Because you are essentially arguing that medicine should be socialized because . . . it’s not socialized.  In science, we call that circular logic.  At Moorewatch, we call it bullshit.

Returning to the subject—these three measures produce a composite number called:

Overall Goal Attainment: This is WHO’s measure of healthcare system quality, socialism and all.  The United States ranks 15th, not 37th.  I repeat, we rank 15th, even when “fairness” is accounted for.  Update: Looking back at their methodology, fairness in health, responsiveness and financial burden is weighted a total of five times as much as customer satisfaction. You can’t let the numbers be biased by those damn morons being satisfied with their unfair systems!

So where does the much-ballyhooed 37th ranking come from?  It’s the WHO’s final number, which is a measure of efficiency—i.e., we have the 15th best healthcare system at the #1 price so we have the 37th best “deal” in the world.

Of course, I’m not sure I want a Consumer Reports “best buy” if I’m getting a pacemaker installed.

But efficiency is a stupid way to measure the quality of a healthcare system.  The more challenges a healthcare system is presented with, the less efficient it will be.  It will spend more money but its populace will still lag in health indicators.

The United States spends more money on healthcare than anyone else in the world. But healthy people don’t spend much on healthcare—they are “efficient”.  Unhealthy people, on the other hand, tend to spend a lot of money on doctors. And the United States is a very unhealthy nation - at least by first world standards.  And we are unhealthy not because of a lack of preventive medicine or “fairness”—we are an unhealthy nation because we eat, drink, smoke, shoot and snort too much and exercise too little.

But now you can see the reason for this post.  By saying “we have the 37th best system at the #1 price” you are double-counting the expense.  The 37th ranking already accounts for our spending.

There are three, no four, ways of looking at the WHO analysis:

You can claim that we have the 15th “fairest” healthcare system in the world at the #1 price.

You can claim that we’re #1 in customer satisfaction at the #1 price.

Or you can claim that we have 37th best “deal”.

Or you can dismiss it as a bad way of measuring a complex problem.

But you can’t run around and repeat 37-at-1 like some mantra.  Because it’s just not true.