NCPA - National Center for Policy Analysis

W.H.O. Report Promotes "Fairness" Over Health

June 28, 2000

Last week, the World Health Organization issued a report ranking the health-care systems of countries throughout the world from best to worst. France topped the list and America came in at 37th place -- just below Costa Rica and fully 15 places below Colombia.

Health-care experts question whether the list should be taken seriously at all. At the very least they ask, "What's going on here?"

  • WHO based its table on an amalgam of life expectancy, freedom to choose one's doctor, application of preventive medicine and fairness in the way health care is financed and delivered.
  • So far as WHO is concerned, "fairness" means that the burden of paying for health care must fall more heavily on the rich than on the poor.
  • Experts point out that new and often expensive medical methods cannot be introduced simultaneously everywhere and equally -- because such a requirement would destroy innovation.
  • It is no accident that medical innovation is by far most rapid in the U.S. -- with its "unfair" system.

An example has been suggested. Imagine two societies, both with 20,000 people who will die without a heart operation. In one society, no such operations are done. In the second, 10,000 operations are performed on the half of the population that is most able to pay for them. Which society has the better health-care system?

From the fairness point of view, the former system -- in which everyone died prematurely -- is clearly superior. It is no consolation to a patient receiving inferior treatment that everyone else is being just as poorly cared for as he is. So absolute fairness is a quality that is inimical to medical progress and innovation.

WHO does admit that the U.S. system is the most responsive in the world to the wishes of individual patients.

Source: Theodore Dalrymple, "'Fair' Health Care Isn't Always Best," Wall Street Journal, June 28, 2000.

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