WHO HEALTH REPORT Japan health systems ranked best (???)

Jim Westrich westrich at miser.umass.edu
Thu Jun 22 08:01:08 PDT 2000



>
>And the US comes 15th on this list. How many league tables do they have
>in this report? And does one of us care enough to read the actual report
>and report back to the list?

I think this has been addressed but I wanted to make some points clear in case anyone is confused.

WHO evaluated health systems and found that Japan is number one in "health level" as measured by disability adjusted life expectancy. There are many problems with this but the most problematic are:

1) that health care systems play only a small role in determining health outcomes (social, physical, and economic environments and other things determine health outcomes). 2) disability adjusted life expectancy is a controversial way of evaluating people. WHO discounts for all physical and cognitive disabilities (there lives are only a "fraction" of a non-disabled life). Unfortunately, I will need to look at the technical report for the details and to find out just how fractional being variously abled is.

They also looked at health expenditure. United States is number 1 here.

Then they looked at health system effectiveness (what they call "overall health system performance") which attempted to look at health outcomes related to their health production frontier (given by health expenditures). This is where France ended 1. (This is the list that Doug posted).

There are other related rankings (United States is 1 in responsiveness but "responsiveness" is measured by asking for people's subjective impression of their health system--so the US is number 1 in "feeling number 1". They have measures of the distribution of health outcomes and the distribution of health finance. Chile is 1 in disability adjusted life expectancy distribution and Columbia is 1 in health care financing fairness (United States is 55th in financing fairness).

All the rankings are at the WHO website (http://www.who.int/whr/)

Peace,

Jim "If you are not a myth, whose reality are you?"

--Sun Ra



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