It's not a rank, it's a (bad) efficiency metric, which says that Ukrainian and Kazakhstan HC is "more efficient" than Russian, and that Chilean HC is "more efficient" than that of Denmark.

If you assume this metric shows what's better, it's safe to assume that this metric is garbage. To lazy to dive into the methodology, they weight the date using avg schooling years and other vague staff, but the results rendering this paper totally unsound.

Comparing different countries using a single "performance" metric is nearly always garbage, since all sorts of important nuances are being omitted.

They are, according to the World health Organization.

Ukrainian healthcare system is more efficient than Russian because you don't have remote regions that have very little or no chances of being reached in case of emergency.

Chile and Denmark are basically at the same level, it shouldn't be a surprise that many South American countries rank at the same level of some western countries.

If you look at the ranking created by other entities, it's more or less the same, even though they used different metrics.

You will always find mostly European countries in the top 20s.

Italy and France really are among the best in the World when it's about healthcare.

USA really is shitty, even though they have the highest spending per capita.

The methodology is well explained, there's an entire chapter explaining it, they are not 'Comparing different countries using a single "performance"', your rebuttal is rebutted.