Health care differs from other consumer goods and services in several ways: the product is ill-defined, outcomes are uncertain, and large segments of the industry are dominated by nonprofit providers. These differences tend to make health care more difficult to compare with other industries when discussing efficiency or effectiveness. But despite the complexities of the industry, a number of questions remain unresolved. For example, how do we define and measure quality, what role does the government play in providing healthcare, and what is the best way to finance it?
The answers to these questions vary among countries. Some, such as Australia and the Netherlands, rank highest in overall performance, while others, including France, rank lower but are still considered world-class. All the countries in this report, however, have strengths and weaknesses, and none is considered perfect. It is important to understand what makes each system unique in order to evaluate them against their peers.
One approach to the issue of comparing healthcare systems is to focus on the level of access and affordability. This approach is based on the notion that health care should be distributed according to a principle of fairness, or at least that it should not be allocated based solely on ability to pay. This theory is rooted in the ethical philosophy of utilitarianism, which holds that the right course of action is the one that brings the most happiness to the greatest number of people.
Another approach focuses on the efficiency of the healthcare delivery process and the cost of financing. This view is based on the idea that the right course of action is one that delivers the most bang for the buck. This theory is rooted in the economic concept of cost-benefit analysis, which weighs alternatives in terms of how much each option costs versus how many lives it saves.
A third approach focuses on the effects of insurance coverage on access and affordability. This theory is based on the fact that having health insurance increases the likelihood that individuals will receive recommended healthcare services, such as cancer screenings or regular check-ups for chronic conditions like high blood pressure and diabetes. Moreover, studies of the effect of insurance on medical outcomes often employ condition-specific designs that minimize the possibility of nonrandom selection bias.
Finally, a fourth approach to the issue of comparing healthcare systems focuses on the overall quality of care. This approach is based on the idea that quality measures should include patient-reported outcomes, provider satisfaction, and process metrics such as prevention, coordination, and sensitivity to individual preferences. It is also important to note that all the countries in this report, except the U.S., have relatively low rates of hospital-based mortality.