The Commonwealth Fund (no, nothing to do with The Commonwealth as we Brits understand it) is an activist group in the US arguing for single payer health care. As a part of that they release reports every now and again attempting to rank the different rich world health care systems. Some years back those reports used to say that the NHS was one of, if not the, best in the world.

This feat was achieved by ranking upon things the NHS does well in. Things like equity of access - note, not speed of, just equity - equality of financing and so on. Vastly more than half the ranking marks came from such arguable definitions of “better” and, as we recall it at least, only 12.5% came from an actual measure of the performance of the health care system as a health care system. That’s the measure of “mortality amenable to health care” where the NHS used to - again according to memory - used to come last.

That is, the NHS was very fair and equitable and not very good.

Fortunately for our fading memories the Commonwealth Fund has just updated their set of measurements, here. By the measures they emphasise the US health care system does very badly - which is their point in the report of course. They are, after all, a group advocating a significant change in the US health care system. Given that neither we nor anyone sentient propose importing the American health care system we can simply note that and move on to what the report reveals about the NHS.

Which is not good. In terms of financing it’s pretty expensive. Below Germany’s 12.8% of GDP at 11.9% for the UK. But above Sweden’s at 11.4%, Holland at 11.2%, Norway at 10.1%.

But on life expectancy the UK is second worst, after the US. On avoidable deaths (that “mortality amenable to health care”) it’s second worst after the US.

This is not a good performance. Relatively expensive and relatively inefficient. Or, to put that another way, a thoroughly bad deal on one of the things we actually want from a health care system, how much health care do we get for our money?

Do note that this information comes from people trying to tell us how bad the US system is. It’s just that when we use those same measures the NHS also isn’t very good - in fact, it’s bad.

All of which would seem to suggest that we get rather more European about our health care system. Or, again in another manner, perhaps we could ask the NHS to worry a little less about equity and equality and a little more about efficiency?