Title: Best Healthcare in the World? Ireland Ranks 6th or 66th
Author: Arthur Harmash
Published: 2026-09-16 (updated 2026-09-30)
Source: https://lymyvoyage.com/articles/best-healthcare-rankings-disagree-ireland-6th-or-66th
Citations:
- https://ceoworld.biz/2025/09/21/countries-with-the-best-health-care-systems-2025/
- https://www.numbeo.com/health-care/rankings_by_country.jsp?title=2025
- https://www.healthcarelabyrinth.com/commonwealth-fund-mirror-mirror-2024-a-portrait-of-the-failing-u-s-health-system-shows-how-much-of-a-healthcare-outlier-america-really-is/
- https://www.numbeo.com/health-care/indices_explained.jsp
- https://europepmc.org/article/MED/25732492
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11861451/
- https://europepmc.org/article/MED/31596745
- https://europepmc.org/article/MED/40608337
- https://www.chicagobooth.edu/review/hospital-ratings-are-deeply-flawed-can-they-be-fixed
- https://europepmc.org/article/MED/21762143
- https://europepmc.org/article/MED/14984279
- https://academic.oup.com/heapol/article/25/5/346/610521
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11195596/
- https://academic.oup.com/jncics/article/4/5/pkaa059/5867917
- https://kffhealthnews.org/health-industry/expanding-number-of-groups-offer-hospital-ratings/
- https://www.wusf.org/health-news-florida/2026-03-09/judge-rules-leapfrogs-safety-ratings-unfair-nonparticipating-hospitals
- https://www.aha.org/news/headline/2026-03-09-florida-district-court-rules-leapfrog-used-deceptive-practices-hospital-safety-rating-system
- https://www.medicaltourism.com/mti/home
- https://www.travelandtourworld.com/news/article/e2yyxylm6xcr/
- https://www.timeout.com/bangkok/news/thailand-named-worlds-second-best-for-medical-tourism-070126
---
In September 2025, CEOWORLD magazine published its Health Care Index and put Ireland 6th in the world.[^1] Numbeo's Health Care Index for the same year put Ireland 66th.[^2] Sweden came 5th on one list and 37th on the other. Canada came 4th and 30th.
Both lists are called a health care index. Both rank most of the world. Neither is lying. They counted different things, and nothing on either page tells a reader what changed between them.
This matters outside the argument about Ireland. "Ranked among the best healthcare systems in the world" is a working sentence in destination marketing, hospital advertising and clinic brochures, and it is almost never sourced.
Ireland ranked 6th in the world for healthcare on one 2025 index, and 66th on another. Both came out the same year. Both are called a health care index. So which one measured healthcare?
Rankings are marketing assets before they are research. A hospital can pay a rating group to use its logo. A country can build a tourism campaign on one line in a list. The people who benefit from a ranking are rarely the people who checked how it was built.
In the US, where the underlying data is best, researchers compared four national hospital rating systems. Not one hospital was rated a top performer by all four. Of the 844 hospitals that one system called high performing, only one in ten got that label from any other system.
The disagreement is not a rounding error. Researchers rescored US hospitals 100,000 times using randomly chosen weights. Nearly half reached the top ten percent at least once. Only 9 percent stayed there reliably.
The consumer indexes measure different things entirely. One of the most-quoted country rankings is built from surveys filled in by website visitors, scoring things like staff friendliness and waiting times. Another scores countries on spending and staffing. Neither counts whether patients survived.
The ratings are not noise. Across nearly 1.9 million US surgical patients, one-star hospitals had a 30-day death rate of 6.8 percent. At five-star hospitals it was 4.9 percent. The direction is real, and it is measured in lives.
What the evidence cannot show is that a good rank means better care for you. In that same study, death rates inside the one-star group ran from 3.6 to 12 percent. The spread within one rating band was as wide as the spread across every hospital.
A ranking is an argument about what counts. Before you trust one, find out what it counted, who filled in the survey, and who gets paid when you believe it.
## The same year, three lists, three answers
Three widely quoted rankings covered 2024 and 2025. Here is where they put the same countries.
| Country | CEOWORLD Health Care Index 2025 (110 countries)[^1] | Numbeo Health Care Index 2025 (134 countries)[^2] | Commonwealth Fund, Mirror, Mirror 2024 (10 countries)[^3] |
|---|---|---|---|
| Taiwan | 1 | 1 | not covered |
| South Korea | 2 | 2 | not covered |
| Australia | 3 | 19 | 1 |
| Canada | 4 | 30 | covered, not top 3 |
| Sweden | 5 | 37 | covered, not top 3 |
| Ireland | 6 | 66 | not covered |
| Netherlands | 7 | 4 | 2 |
| Japan | 13 | 3 | not covered |
| United Kingdom | outside top 15 | 21 | 3 |
| United States | 15 | 38 | 10 (last) |
Two countries are stable. Taiwan and South Korea take the top two places on both global indexes, which is the strongest agreement anywhere in the table. After that the lists come apart. Japan is 3rd on one and 13th on the other. Ireland moves 60 places.
The Commonwealth Fund's comparison measures something different again. It ranks only 10 high-income countries across 70 measures in five areas: access to care, care process, administrative efficiency, equity and health outcomes.[^3] Australia comes first, the Netherlands second, the United Kingdom third. The United States comes last overall while ranking 2nd on care process.[^3] That single result shows how much the choice of measure decides the answer.
## What each index actually counted
Numbeo's index is a perception survey. The company says its health care data comes from surveys answered by website visitors.[^4] Respondents score eight things. Four of them are skill and competence of staff, speed of examinations, modern equipment, and accuracy of reports. The other four are friendliness and courtesy, waiting times, convenience of location, and cost. Cost is weighted twice.[^4]
Numbeo is open about this. Its own methodology page says the data "could be subject to biases" and is "based on user-contributed data and perceptions, which may vary."[^4] That caveat does not travel with the ranking when someone quotes it.
CEOWORLD counts inputs rather than perceptions. Its index scores 110 countries on five things.[^1] Those are healthcare infrastructure, the competence of health workers, cost per person per year, availability of quality medicine, and government readiness. None of the five is a patient outcome.
So a country can climb the CEOWORLD list by building more hospitals and hiring more staff, and climb the Numbeo list by having friendlier reception desks and shorter queues. Neither movement requires a single patient to get better. Both produce the same headline.
## The US hospital ratings disagree in the same way
Country league tables are easy to dismiss as loose journalism. The more uncomfortable evidence comes from US hospital ratings, where the data is far better and the disagreement is just as large.
In 2015, a team led by J. Matthew Austin compared four national rating systems: US News & World Report, Healthgrades, Leapfrog and Consumer Reports.[^5] No hospital was rated a high performer by all four. Of the 844 hospitals rated a high performer by one system, only 10 percent were rated a high performer by any other.[^5]
That finding has held up. A 2024 study in the Journal of General Internal Medicine compared ratings for 2,384 acute care hospitals.[^6] Between Hospital Compare, the federal rating, and Leapfrog, ratings were discordant for 70 percent of hospitals. For 25.1 percent the gap was two rating levels or more.[^6]
A third team narrowed the question to one specialty: orthopaedic surgery. Across 1,640 hospitals rated by five systems, not one was ranked high performing by all five.[^7] Agreement between any two of the systems was close to none, with a Cohen's kappa below 0.10 on a scale where zero means chance.[^7]
The comparison the authors ran next is the striking one. A hospital was called high performing by one system and low performing by another 10.66 percent of the time, against 3.76 percent for the majority verdict.[^7] That is nearly three times as often.
A hospital was more likely to be called high performing by one rating system and low performing by another than to be called high performing by most of them.[^7]
Three research groups reached that result independently, using different rating systems, nine years apart. This is the kind of corroboration the consumer indexes have never had.
## Move the weights and the winners change
Ratings combine many separate measures into a single score, and how much each measure counts is a choice made by whoever built the rating. It is not a fact about hospitals.
A 2025 study in JAMA Network Open tested what that choice is worth. The authors took the 45 quality measures behind the federal Overall Hospital Quality Star Rating and rescored 2,700 hospitals 100,000 times, using randomly generated weights each time.[^8] They then asked which hospitals reached the top 10 percent reliably, meaning in at least half the simulations.
A total of 1,287 hospitals, or 47.7 percent, reached the top 10 percent in at least one simulation. Only 244 hospitals, or 9 percent, did so reliably.[^8]
Put plainly: nearly half the hospitals studied could be called one of the best 10 percent, if you pick the weights to suit. Dan Adelman, a researcher at Chicago Booth who studies rating instability, put the same point in one sentence. "You move the weights around a little bit, and all of a sudden all the top hospitals change."[^9]
## Country league tables have the harder problem
International comparisons add a second failure on top of the weighting problem: the underlying numbers are not collected the same way.
A 2012 study in Health Services Research applied patient safety indicators across 15 countries.[^10] It used hospital discharge records from Belgium, Canada, Germany, Italy, Spain, the United Kingdom, the United States and eight others. The authors concluded that international comparisons based on unadjusted patient safety indicators "are problematic due to suspected coding or ascertainment bias."[^10] A country that records complications more thoroughly looks less safe.
The same problem shows up inside one country. Researchers found that after a US rule change let hospitals report more diagnosis codes, the share of submissions carrying 11 or more codes rose sharply. They estimate half of the apparent improvement in readmission rates may have come from better coding rather than better care.[^9]
Efficiency rankings fail a different test. In 2003, Hugh Gravelle and colleagues reanalysed the World Health Organization's own health system efficiency data for up to 141 countries.[^11] They found that "country rankings and efficiency scores are sensitive to the definition of efficiency and choice of model specification."[^11] Their conclusion was blunt. It was "premature to use the methods adopted by the WHO to construct league tables of health systems."[^11]
That judgement lands on the most famous health ranking ever published. The World Health Report 2000 ranked the health systems of 192 member states, putting France first and the United States 37th.
Martin McKee reviewed that report 10 years on in Health Policy and Planning. He noted that its responsiveness scores came from "a survey of 1791 respondents in 35 countries, many of whom were WHO staff."[^12] He also flagged results that failed a common-sense check, including Colombia ranking above Canada on fairness of financing.[^12] WHO has not repeated the exercise in that form.
## Where the ratings do hold up
The evidence cuts both ways, and the other side of it is substantial.
In 2024, a team publishing in JAMA Surgery looked at 1,898,829 Medicare patients having one of five operations between 2014 and 2018.[^13] Thirty-day death rates were 6.80 percent at one-star hospitals and 4.93 percent at five-star hospitals. Serious complications ran 19.2 percent against 14.3 percent.[^13] The federal star rating does track something real.
A separate study of 105,823 complex cancer operations found 90-day death rates of 10.4 percent at one-star hospitals and 6.4 percent at five-star hospitals.[^14] Two independent teams, two different patient groups, same direction.
Both teams also limited their own finding. The cancer researchers calculated that 26 patients would have to switch hospitals to save one life. They called that "relatively inefficient and of only modest impact."[^14]
The surgical team went further. Death rates inside the one-star group ranged from 3.6 to 12.0 percent, and inside the five-star group from 2.4 to 9.1 percent.[^13] There was, in their words, as much variation within each star rating as across all hospitals.[^13]
The disagreement studies point the same way on this. In the 2024 comparison of 2,384 hospitals, ratings from Hospital Compare and Leapfrog still correlated positively, at a Spearman coefficient of 0.37.[^6] That is a weak relationship rather than no relationship at all.
So the ratings predict something on average. What they do not do is tell you much about the one hospital you are actually considering.
## What the headline numbers leave out
Three things almost never appear alongside a ranking claim.
**Ratings are a product.** Hospitals pay licensing fees to advertise their awards. Hospital executives interviewed by KFF Health News in 2013 put the price of using the Healthgrades logo at $145,000.[^15] US News was around $50,000 and Leapfrog $12,500.[^15] Those were the fees a decade ago, and none of the three publishes a current price list.
Healthgrades says an award cannot be bought, only achieved.[^15] The fee buys the logo, not the grade. Both things can be true. The revenue still gives rating groups a reason to produce different lists of winners.
**Non-participation can become a bad grade.** In March 2026, a US federal judge in Florida ordered the Leapfrog Group to withdraw safety grades for five Tenet-owned hospitals.[^16] Leapfrog automatically gave the lowest score to hospitals that did not fill in its voluntary survey. That penalty was worth roughly a third of the final grade.[^16]
Judge Donald Middlebrooks found the change had "no scientific basis, unfairly penalizes non-participating hospitals, and misrepresents hospital safety."[^17] Leapfrog said it disagrees and would appeal.[^16]
**Medical tourism rankings are often opinion.** The Medical Tourism Index, widely cited in the industry, ranked 46 destinations by surveying 3,030 Americans.[^18] Canada came first and Singapore second.[^18] Turkey and Thailand, first and second on the trade ranking described below, do not appear in its top 10 at all.[^18]
The trade site Travel And Tour World published its own top 50 for 2026, with Turkey first and Thailand second. It states only that the list was "Developed by TTW's editorial experts", naming no dataset and no scoring formula.[^19] Time Out Bangkok reported the result as news.[^20]
## How to read a ranking claim
A ranking is a set of choices about what counts. You can test those choices in about two minutes.
Find out what was measured. If the index scores spending, staffing or equipment, it is measuring resources, not results. If it scores friendliness and waiting times, it is measuring experience.
Find out who was asked. A survey of website visitors and a registry of hospital discharge records are not the same evidence, even when both produce a number out of 100.
Check a second list for the same year. If the two disagree by 60 places, as CEOWORLD and Numbeo do for Ireland, neither number is telling you about care quality.
Then go past the ranking. For a specific procedure at a specific hospital, ask for its own volume for that operation, its complication and revision rates, and who handles follow-up if something goes wrong. A national or country-level rank cannot answer any of those questions, and no ranking studied here claims it can.
[^1]: https://ceoworld.biz/2025/09/21/countries-with-the-best-health-care-systems-2025/ — CEOWORLD magazine, "Countries With The Best Health Care Systems, 2025" (published Sep 21, 2025). Accessed Sep 16, 2026.
[^2]: https://www.numbeo.com/health-care/rankings_by_country.jsp?title=2025 — Numbeo, "Health Care Index by Country 2025". Accessed Sep 16, 2026.
[^3]: https://www.healthcarelabyrinth.com/commonwealth-fund-mirror-mirror-2024-a-portrait-of-the-failing-u-s-health-system-shows-how-much-of-a-healthcare-outlier-america-really-is/ — The Healthcare Labyrinth, "Commonwealth Fund 'Mirror, Mirror 2024'" (published Sep 23, 2024), reporting Commonwealth Fund data. Accessed Sep 16, 2026.
[^4]: https://www.numbeo.com/health-care/indices_explained.jsp — Numbeo, "Understanding Health Care Indexes". Accessed Sep 16, 2026.
[^5]: https://europepmc.org/article/MED/25732492 — Austin JM, Jha AK, Romano PS, et al., "National hospital ratings systems share few common scores and may generate confusion instead of clarity", Health Affairs 34(3):423-430 (published Mar 2015); record via Europe PMC. Accessed Sep 16, 2026.
[^6]: https://pmc.ncbi.nlm.nih.gov/articles/PMC11861451/ — Badr S, Nahle T, Rahman S, et al., "Hospital Rating Organizations' Quality and Patient Safety Scores: Analysis of Result Discrepancies", Journal of General Internal Medicine 40(3):525-531 (published Jul 19, 2024). Accessed Sep 16, 2026.
[^7]: https://europepmc.org/article/MED/31596745 — Shah RF, Manning DW, Butler BA, Bilimoria KY, "Do Hospital Rankings Mislead Patients? Variability Among National Rating Systems for Orthopaedic Surgery", Journal of the American Academy of Orthopaedic Surgeons 28(17):e766-e773 (published 2020); record via Europe PMC. Accessed Sep 16, 2026.
[^8]: https://europepmc.org/article/MED/40608337 — Pollock BD, Ubl DS, Devkaran S, Dowdy SC, "Simulating the Overall Hospital Quality Star Ratings With Random Measure Weights", JAMA Network Open 8(7):e2519029 (published 2025); record via Europe PMC. Accessed Sep 16, 2026.
[^9]: https://www.chicagobooth.edu/review/hospital-ratings-are-deeply-flawed-can-they-be-fixed — Chicago Booth Review, "Hospital Ratings Are Deeply Flawed. Can They Be Fixed?" by Brian Wallheimer (published Aug 26, 2020), reporting research by Dan Adelman and by Ody, Msall, Dafny, Grabowski and Cutler. Accessed Sep 16, 2026.
[^10]: https://europepmc.org/article/MED/21762143 — Drösler SE, Romano PS, Tancredi DJ, Klazinga NS, "International comparability of patient safety indicators in 15 OECD member countries", Health Services Research 47(1 Pt 1):275-292 (published 2012); record via Europe PMC. Accessed Sep 16, 2026.
[^11]: https://europepmc.org/article/MED/14984279 — Gravelle H, Jacobs R, Jones AM, Street A, "Comparing the efficiency of national health systems: a sensitivity analysis of the WHO approach", Applied Health Economics and Health Policy 2(3):141-147 (published 2003); record via Europe PMC. Accessed Sep 16, 2026.
[^12]: https://academic.oup.com/heapol/article/25/5/346/610521 — McKee M, "The World Health Report 2000: 10 years on", Health Policy and Planning 25(5):346-348 (published Sep 2010). Accessed Sep 16, 2026.
[^13]: https://pmc.ncbi.nlm.nih.gov/articles/PMC11195596/ — Diaz A, Harbaugh C, Dimick JB, Kunnath N, Ibrahim AM, "Variation in Postoperative Outcomes Across Federally Designated Hospital Star Ratings", JAMA Surgery (published Jun 18, 2024). Accessed Sep 16, 2026.
[^14]: https://academic.oup.com/jncics/article/4/5/pkaa059/5867917 — Papageorge MV, Resio BJ, Monsalve AF, et al., "Navigating by Stars: Using CMS Star Ratings to Choose Hospitals for Complex Cancer Surgery", JNCI Cancer Spectrum 4(5):pkaa059 (published Jul 7, 2020). Accessed Sep 16, 2026.
[^15]: https://kffhealthnews.org/health-industry/expanding-number-of-groups-offer-hospital-ratings/ — KFF Health News, "Hospital Ratings Are In The Eye Of The Beholder" by Jordan Rau (published Mar 18, 2013). Accessed Sep 16, 2026.
[^16]: https://www.wusf.org/health-news-florida/2026-03-09/judge-rules-leapfrogs-safety-ratings-unfair-nonparticipating-hospitals — WUSF Health News Florida, "U.S. judge rules Leapfrog's safety ratings were unfair to nonparticipating hospitals" by Rick Mayer (published Mar 9, 2026). Accessed Sep 16, 2026.
[^17]: https://www.aha.org/news/headline/2026-03-09-florida-district-court-rules-leapfrog-used-deceptive-practices-hospital-safety-rating-system — American Hospital Association, "Florida district court rules Leapfrog used deceptive practices for hospital safety rating system" (published Mar 9, 2026), quoting the ruling of Judge Donald M. Middlebrooks. Accessed Sep 16, 2026.
[^18]: https://www.medicaltourism.com/mti/home — Medical Tourism Association and International Healthcare Research Center, "The Medical Tourism Index 2020-21". Accessed Sep 16, 2026.
[^19]: https://www.travelandtourworld.com/news/article/e2yyxylm6xcr/ — Travel And Tour World, "TTW Announces Top 50 Medical Tourism Destinations in the World for 2026" (published Jun 20, 2026). Accessed Sep 16, 2026.
[^20]: https://www.timeout.com/bangkok/news/thailand-named-worlds-second-best-for-medical-tourism-070126 — Time Out Bangkok, "Thailand named top-two medical tourism destination for 2026" (published Jul 1, 2026), reporting the Travel And Tour World list. Accessed Sep 16, 2026.