Target Health Blog

Bloomberg U.S. Health Care Index

November 4, 2018


A group of Chilean 'Damas de Rojo' volunteering at their local hospital
Photo credit: Diego Grez, CC BY-SA 3.0,

Editor's note: It's not rocket science to figure out that if all the people around you, and that you come in contact with, are healthy, your odds of being healthy also, are very high. The countries on the planet that have Universal Healthcare, are also the healthiest countries in the world. Interestingly, these healthy countries also come in high on the Happiness Index. If the air you breathe is polluted, all the money in the world can not make this health risk go away. Following good health guidelines, will lower the risk for all income groups.

Bloomberg News recently ranked countries based on a Health-Efficiency Index which tracks medical costs and value by reviewing life expectancy and health-care spending measures by economy. The index ranks those with average lifespans of at least 70 years, GDP per-capita exceeding $5,000 and a minimum population of 5 million.

Want medical care without quickly draining your fortune? Try Singapore or Hong Kong as your healthy havens. In 2018, the healthiest in the world on the Bloomberg list are:

1. Hong Kong

2. Singapore

3. Spain

4. Italy

5. South Korea

These are followed by:

6. Israel

7. Japan

8. Australia

9. Taiwan

10. U.A.E.

The health-efficiency index was created to rank those with average lifespans of at least 70 years, GDP per-capita exceeding $5,000 and a minimum population of 5 million.

The U.S. will cost you the 1) ___ for treatment, both in absolute terms and relative to average incomes, while life expectancy of Americans -- about 79 years -- was exceeded by more than 25 countries and territories, according to an annual Bloomberg analysis in almost 200 economies. Americans aren't getting their medical 2) ___ worth, according to each of the categories. The U.S. had the second-highest per-capita spending on health care at $9,536. Switzerland's average based on gross domestic product was $9,818. But that $282 supplement helped deliver an extra 4.2 years of life -- with the average Swiss lifespan of almost 83. The U.S. Health system ranked among the least efficient in the world.

Compared to residents of the Czech Republic -- which had an average life expectancy almost at parity with the U.S. -- Americans spent more than double on health care relative to GDP, 16.8% versus 7.3%. Health spending in the U.S. is estimated to increase to 18% of GDP in the U.S., according to estimates from the Altarum Institute. The U.K. fell out of Europe's top 10 in the health ranking based on 2015 data. The nation voted in favor of Brexit the following year, with costs and efficiency of the National Health Service a key issue for British voters; of course, Brexit didn't make healthcare better. However, the U.K. healthcare 3) ___ is still far better and more fair than the U.S. Spain's health system efficiency ranked third behind Hong Kong and Singapore, followed by that of Italy, which moved up two spots from a year earlier. In 2017, Italy ranked as the world's healthiest 4) ___ in a separate Bloomberg gauge. Thailand moved up 14 places to No. 27, the biggest annual improvement, as per-capita spending declined 40% to only $219, while life expectancy advanced to 75.1 years. Medical 5) ___ industry is among Thailand's fastest-growing industries. Chile, highest-ranked from Latin America last year, tumbled 23 positions, out of the top 10 to 31st, well behind Mexico and Costa Rica, but still ahead of the U.S. The Chilean government spent 28 basis points more on health expenditure relative to annual GDP, while 6) ___ longevity of its citizens fell more than two years. Israel and the U.A.E. ranked highest among Middle 7) ___ economies, with both remaining in the top 10 from last year's survey.  Costa Rica, Ireland, Lebanon and New Zealand were added to the final index this year, having reached the population threshold -- all now ranking among the top 25. Again, all ahead of the United States.

Rankings can change substantially year-over-year because of such things as recession, currency fluctuations and volatile spending patterns relative to the slow pace of improvement in life expectancy. Rankings can change substantially year-over-year because of such things as recession, currency fluctuations and volatile spending patterns relative to the slow pace of improvement in life expectancy.

Notes: Total health expenditure generally includes preventive and curative health services, family planning, nutrition activities and emergency aid; Relative cost is measured by total health expenditure as a percentage of GDP and absolute cost is the simple per capita total health expenditure in nominal dollar terms. The Bloomberg Global Health Index recently ranked the world's healthiest (and unhealthiest) countries based on several factors including life expectancy, health risks (ie. tobacco use and high blood pressure), availability of clean water, malnutrition and causes of death. Coming in first in 2017, with a health grade of 93.11 out of 100 was Italy, where babies born today can expect to live well into their 80s. Perhaps it's taking in the country's beautiful coastlines or exploring its plentiful historic sites that keep the Italian brain and body feeling young. Or it could be Italy's heart-healthy Mediterranean 8) ___, which includes a plethora of vegetables, extra virgin olive oil, fresh seafood, a healthy dose of wine and spending time relaxing with family and friends (mental health is important, too).

Coming in second place, in 2017 with an average lifespan of 81 years was Iceland, that also ranked high in this year's list of the world's happiest countries. While an Icelandic diet is not particularly similar to that of Italy ? there's a lot of lamb and dairy as well as other delicacies like fermented shark ? the two countries are similar in that their food is incredibly fresh, with most of it in Iceland being locally-sourced. The third place in 2017 was Switzerland, a country known for its gorgeous natural scenery and active, outdoorsy lifestyle. The Swiss also have a universal healthcare system that's thought to be one of the best in the world. Singapore made it into the fourth spot and while the cuisine there might not be the paramount factor in its citizens' longevity - it's mainly influenced by Malaysian, Chinese, Indian and Indonesian cuisine - the country is extraordinarily clean and has one of the world's best healthcare systems. Rounding out the top five healthiest countries is the sunny land down-under, Australia. Despite being home to some of the world's most dangerous animals, Aussies are still likely to live quite a long and healthy life. Perhaps it's the abundance of sunshine, beaches and outdoor activities or the overall happy-go-lucky nature of the people who live there, but clearly, they're doing something right. Spain, Japan, Sweden, Israel and Luxembourg finished out the top 10, while the remaining 15 countries in the top 25 appeared in the following order, starting with 11th place: Norway, Austria, the Netherlands, France, Finland, Germany, Canada, Cyprus, New Zealand, Greece, Portugal, Ireland, the UK, South Korea and Malta.

When it comes to living a long life, 9) ___ is a good place to be. Italy, surrounded by five seas is ranked one of the healthiest country on 10) ____ in the Bloomberg Global Health Index of 163 countries. A baby born in Italy can expect to live to be an octogenarian. But 2,800 miles south in Sierra Leone, the average newborn will die by 52. While Italy is among the most developed countries, growth has stagnated for decades, almost 40% of its youth are out of jobs and it's saddled with one of the world's highest debt loads relative to the size of its economy. Yet Italians are in way better shape than Americans, Canadians and Brits, who all suffer from higher blood pressure and cholesterol and poorer mental health.

Sources: Bloomberg Global Health Index; World Bank,; World Health Organization, UN Population Division, International Monetary Fund, Hong Kong Department of Health, Taiwan Ministry of Health and Welfare

ANSWERS: 1) most; 2) money's; 3) system; 4) country; 5) tourism; 6) longevity; 7) East; 8) Diet; 9) Italy; 10) earth

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