suppose that a country currently provides everyone the same quality of health care. And then suppose the quality of health care improves for half of the population, while remaining the same (not getting any worse) for the other half. This should be regarded as an unambiguous improvement: some people become better off, and no one is worse off. But in the WHO index, the effect is ambiguous. An improvement in average life expectancy would have a positive effect, while the increase in inequality would have a negative effect. In principle, the net effect could go either way.
Almost two-thirds of the weight in the WHO index goes to these distributional factors. They focus more on inequality than on the absolute level of care received by the poor. In fact, if you dig deeply, what WHO is really measuring is not even inequality in terms of health services but just plain income inequality. Just having very rich people per se is enough to lower the quality of our health care system, according to WHO’s methodology.
I am no fan of U.S. health care. But WHO’s approach to health care rankings strikes me as all noise and no signal.
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