The International Policy Network in London has published a new paper for the Campaign for Fighting Diseases (CFD) that is a major contribution to the debate about how the U.S. stands among other nations on health care. You recall, of course, that the World Health Organization claims we rank 37th.

"The WHO rankings are highly influential amongst policymakers, and help drive health reforms all over the world," the CFD says. "Yet they show the USA to have a worse healthcare system than Morocco or Costa Rica — which is clearly absurd."

The CFD paper finds serious flaws with the troublesome report by the WHO, popularized in Michael Moore's SiCKO movie.

The new paper is descriptively entitled, "Trouble in the Ranks: How the World Health Organization unfairly evaluates national health care systems" and was written by Glen Whitman, an economics professor at California State University at Northridge.

Prof. Whitman concludes that countries were much more likely to get high marks from WHO if everyone in a country gets the same poor quality of care, especially if the system is socialized and tax-funded, than if a country excels in medical care but where access may be unequal.

He also points out numerous structural flaws in the WHO study:

The WHO report accepts an 80% uncertainty interval in the random samples of data collected for each country in the ratings. An 80% uncertainty level? That's virtually useless data!

Also, the study uncovers the WHO's ideological bent. For example, countries with a high level of paternalism get high marks: Health systems should be responsible not only for treating lung cancer, but for preventing smoking in the first place; not just for treating heart disease, but for getting people to exercise and lay off the fatty foods, Whitman says.

As we have written before, the rankings fail to include absolute healthcare measures, such as five-year cancer survival rates — critical indicators of a health system's performance, especially if you are sick and need medical care.

Prof. Whitman concludes: "These rankings are rooted in ideological beliefs and certainly not empirically-balanced and objective as the WHO claims. People interested in genuinely objective measuring of different systems, particularly for developing countries, should look elsewhere for evidence."