In my last article for Talkmarkets I described the factors and weights used in my macro-globanomic model to evaluate the overall performance of the 238 nations of the world. Now it is time to begin showing some results from the model.

A good way to start is by discussing the results from the Health Care module which accounts for 15% of the overall rating of a nation’s performance. The Health Care module is one of three criteria evaluated in the second hierarchical level of my model called Secondary Essentials. Besides the Health Care module, the Secondary Essentials hierarchical level also includes a module for Sanitation and a module for Personal Safety, both accounting for 5% of a country’s overall performance.

In order to gain a sense of how the Health Care module evaluates a nation’s Health Care performance a partial list of the criteria should suffice as an explanation:

• Life expectancy for citizens of a country;
• Health care expenditures as a percent of GDP or Purchasing Power Parity, (PPP);
• Health care expenditures per capita;
• Neonatal deaths within 28 days of birth per 1000 births;
• Deaths within 1 year of birth per 1000 births;
• Deaths with 5 years of birth per 1000 births;
• Deaths between the ages of 5 and 15 years per that age group population;
• Prevalence of obesity in adult population;
• Immunization percentage;
• Number of doctors per capita;
• Number of nurses and midwifes per capita;
• Number of cigarettes smoked per capita.

Now without hesitation let us look at the results for the peer group of twenty-nine nations of which the United States is a part. As I mentioned above, my Health Care module accounts for 15% of a nation’s total score in my macro-globanomic model. In other words, a score of 15.0 would reflect a perfect score, requiring a nation to have the best peer group numbers in every category of evaluation. The 29 nations in the following table account for 83.5% of the world’s population and 78.2% of the worlds GDP (PPP).   

From the above table you can see that I have broken down this peer group of nation’s further into four distinct tiers. The good news for the United States is that it made the first tier. The bad news for the United States is that it is scores at the bottom of this first tier. 

Ah, now come on, Jim. Something must be wrong in the way you are making your evaluation.The United States spends more than twice the amount per capita ($9,536) and much more in relation to its GDP (17.1%) on health care than any other nation in the world. Add to that the fact that health care costs in the United States are managed mostly by private health care systems, not by some obscene government enterprise, your analysis must be flawed.

Listen folks, to my counter to that argument. First, I would like to point out that I have a Wharton M.B.A. and I do very much believe in the private sector. I am no more biased towards government operations than business operations. In my lifetime I have seen great things accomplished by both sectors within the United States. But when I look at the health care numbers for the United States, I almost become sick and can almost feel my own health care deteriorate. 

For example, let us look at the following table to see how the average numbers for just some of the criteria that I use in my globanomic health care module play out for each of the four tier group’s shown in the earlier table. The numbers for the United States are part of the first-tier group averages and displayed separately by themselves at the bottom of the table. 

Looking at the above table, I would hope my followers first recognize the rather telling correlation between health, each health care criterion, and each tier group. For example, note how life expectancy deteriorates between higher tier groups and lower tier groups. Note how infant deaths increase for lower tier groups. Note how health expenditures decrease from top tier and lower tier groups. This is a common phenomenon that I have seen in many Performance Evaluation Report Card (PERC) efforts that I have performed in the past. Good performers tend to perform better than poor performers in most criterion categories and so is the case I have discovered, with my globanomic Health Care evaluation.

What upsets me as a blue-blooded American, however, is this. Why are our numbers not better than they are? My globanomic Health Care module places 20% of its weight on health care expenditures (i.e., per GDP (PPP) and per capita). Three points (15 times 20%) in the total United States health care score of 10.33 comes from its high health care expenditures. The next best country in the health care expenditure area (Germany) receives 2.1 points in my globanomic model. 

Health care expenditures within a country do correlate highly to overall national health - that can be seen from the above table and that is why my globanomic model considers it a relevant factor. However, despite the overall world-wide correlation between health care expenditures and health care itself, the same correlation does not hold within Tier Group 1 - the only tier group I might add, where this correlation does not hold.

Again, I ask the question. What are we getting for our health care dollars in the United States? We spend twice as much per capita as any other nation, but we have lower life expectancies than all other tier group 1 nations. We have more infant deaths than other tier group 1 nations. We have fewer doctors than most tier 1 nations. We have more obesity than every other tier 1 nation. Even our immunization numbers are below the average for most tier 1 nations.

Now if you are not getting sick or upset yourself reading this, let me show you some additional analysis that I performed outside of my globanomic analysis. In that analysis I wanted to see how some of the health care insurance companies in the United States have performed in the marketplace over the past twenty-years. The way I went about this was to look at how various U.S. health insurance companies stock value changed in relation to the DOW (DIA), NASDAQ (QQQ), JPM, AAPL, XOM, WMT, IBM, and others. When I performed this analysis, I looked at stock performance from three different time perspectives: (1) for 20 years from Jan 1, 2000 to Jan 1, 2020; (2) from the time Facebook (FB) became public (May 1, 2012) to Jan 1, 2020; and (3) in the first three years of new leaders presidency from Jan 1, 2017 to Jan 1, 2020. 

The results are amazing.The following table shows stock price growth over the three different time periods and for several of the indices and companies mentioned above.

Now I am not going to interpret the above table for you, but I would like to say that major U.S. health care insurance companies seem to have performed quite well for their investors regardless of what period of time one wants to look at. The sad thing is that stock performance does not seem to correlate with health care performance. Go figure. It makes me wonder who really does benefit from our private sector driven health care system? And now as this coronavirus thing plays out, I can only hope our health insurance and drug companies come through for us. I am keeping my fingers crossed.

In my next article I will show how the United States scores in the Primary Essentials areas of Food, Water, and Shelter. Until then, stay healthy my friends.