Rating and Evaluating Health Systems: The Value of the Life Expectancy Approach.

Cross-national ranking and rating of public services does not always provide the conditions for effective cross-national learning, because such learning requires causal understanding of the mechanisms underlying ranking scores. That causal understanding means grappling with the production functions involved in public services, and it is particularly difficult for organizations or policy domains where processes are more readily measurable than outcomes relative to goals. Health is to a large extent a policy domain of that type, which makes effective ranking and comparison difficult and also presents a particular challenge for cross-national learning. Numerous attempts have been made to compare the efficiency of different health care systems, and though there is a certain logic about such approaches to ranking and rating, this paper argues that much can be learnt for health policy using life expectancy as the basis for ranking and comparison. [ABSTRACT FROM AUTHOR]