Rankings Based on Outcomes

Today's Wall Street Journal printed my letter to the Editor on the value of rankings focused on outcomes, a topic that has occupied this space often:

Most “number guys” can criticize performance measures, especially rankings, in their sleep because most measures are imperfect. Carl Bialik (“Ill-Conceived Ranking Makes for Unhealthy Debate,” The Numbers Guy, Oct. 21) takes the easy route for a cheap shot at the dated and flawed World Health Care low 37th ranking of the U.S. in the world in health care. He suggests that the “unhealthy debate” caused by the U.S. ranking would be cured by more methodological rigor and that, in any event, we shouldn’t rank everything, especially health care. I wonder if Mr. Bialik thinks that our debate about health care would be healthier if the U.S. ranked let’s say 12th in the world using methods that pass muster with the scientific community. I suspect that most of us would like to see the U.S. in first place and that even 12th place would not change what we think of health care today. Americans love rankings, the top-ten of whatever including cities, high schools and universities, hospitals and toasters. I think rankings of health care are here to stay and that’s a good thing. As flawed as they may be, they focus attention of the debate where it should be, on outcomes.

Ingo Keilitz
Williamsburg, Virginia

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