Total health spending and its share in the social product have been staple indicators in assessing and comparing health care systems. Comparison of health care systems based on Euros and cents is limiting, however, since the health care system is not an artifact of the economy. Institutions shape societal values on health care leading to peculiarities even among health care systems that share traditions in terms of health care financing and delivery.   This paper presents a framework to compare health care systems in a meaningful way that accounts for systemic differences and similarities using the empirical technique cluster analysis.  The analysis will follow a three-step procedure.  A review of the literature will be conducted to identify major institutional indicators of any given health care system. Cluster analysis will then be employed using these indicators based on data of OECD member countries.  Based on the isolated clusters using the “minimum description length” approach, “peer” health care systems will be identified and described highlighting so-called leaders of the pack. At the heart of the performance of every health care system is the extent to which it is able to respond to the desire for a healthy life by members of society.  This implies accounting for both efficiency, which investigates the link between the link between health care resources and health outcomes, and effectiveness, which assesses the achievement of goals rather than choosing one over the other.  Assessing health care systems against peers and over time would not only set systems apart given their shared intent of ensuring health by providing health care but may well engender learning and lead to a race to the top.