The Mirror, Mirror series
The Commonwealth Fund, a US-based health policy foundation, publishes a periodic comparison of health systems across a set of countries under the title Mirror, Mirror. Each edition scores the same group of countries against a common set of domains, such as access to care, care process, administrative efficiency, equity and health outcomes, and combines these into an overall ranking for that edition.
The 2024 edition
The most recent edition, Mirror, Mirror 2024, was published in September 2024 and compared ten countries. It placed the United Kingdom among the top three of those ten, alongside Australia and the Netherlands.
Earlier editions exist and covered their own sets of countries and domains, but each edition's scope and method are its own. A rank from one edition cannot be read straight onto another without checking what that edition measured and when it was published, which is why each edition's own figures and its own methodology note are worth reading together rather than apart.
Overall rank compared with domain rank
Each edition of the series publishes two different kinds of position, and reading them side by side shows where a change in the headline figure is actually coming from.
| Rank type | What it reflects | What it does not show |
|---|---|---|
| Overall rank | The country's position once every domain measured in that edition is combined into one figure | How the country did in any single area, such as access to care or health outcomes |
| Domain rank | The country's position within one specific area measured in that edition | How that domain weighs against the others in the combined figure |
The overall rank and domain rank for each published edition, with its publication date, are set out edition by edition further down this page.
Reading the caveat behind each edition's figures
Each edition of the Commonwealth Fund's Mirror, Mirror series sets out its method before it sets out its figures: which countries took part, which indicators went into each domain, and how those indicators were combined to produce an overall rank. That note sits alongside the numbers in the edition itself, and it is worth reading before treating any single rank as fixed.
What a caveat usually covers
A methodology note of this kind typically states which countries supplied data for that edition, which surveys or administrative datasets fed each domain, and whether a domain was scored on the same basis as in the edition before it. Some editions add or drop a domain altogether, or change what counts as evidence within one.
What changes between editions
Because the indicators behind a domain score are not fixed from one edition to the next, a change in the UK's rank between two editions can reflect a change in how that domain was measured. The edition's own caveat is the place to check which of the two is more likely.
What the series can and cannot show
Reading the editions in sequence shows where the UK's reported position has moved over time, but only for the domains and countries that were scored on a comparable basis in each edition being compared. Where the method changed, the honest comparison is between what each edition says about itself. The way every figure on this site is sourced and dated is set out on the data and sources page, for a reader who wants to check a figure against the publisher's own release.