Political Bias in WHO Health System Rankings

A new report from the CFD reveals the WHO health system rankings to be statistically dubious and biased towards taxpayer-funded systems.

Influential among policy-makers, the rankings are also widely cited in media reports as impartial measures of health system performance. Michael Moore predictably cited the US system’s low rank in his film SiCKO. But the USA ranks lower than Morocco and Costa Rica, which is clearly absurd!

Our analysis shows that the rankings do not measure health system performance – over half (62.5%) of their weighting concerns equality rather than quality of service.

A further 25% concerns life expectancy – which is affected by factors unrelated to the healthcare system such as tobacco use and other drug use, diet and even homicide rates.

In the only real measure of health system performance – ‘Responsiveness’ – the US comes out number 1 in the world.

Incredibly the rankings ignore commonly-used measures of healthcare systems such as disease-specific mortality and survival rates. They do, however, give a quarter of their weight to ‘Financial Fairness’, a measure which inherently favours taxpayer-funded systems.

Last month there was a health systems conference in Africa. This week Commonwealth health ministers meet in Geneva. Next month there is a European ministerial conference on health systems.

Ministers and policy-makers at such events should be aware of the WHO rankings’ flaws, and look elsewhere for fairer international comparisons of healthcare systems.

Click here for the report.