Key keywords: health care policy evaluation, Kaj Samsom commentary, public health outcomes, health equity metrics, health care access, universal health coverage, policy performance assessment, catastrophic health expenditure In his newly published, widely circulated commentary, leading global health policy analyst Kaj Samsom argues that governments and public health agencies have long prioritized the optics of health care policy announcements over the tangible impacts those policies deliver to communities, calling for a universal shift to outcome-based assessment for all public health initiatives. Samsom, who has advised 12 national governments on health system reform over the past 15 years, notes that far too many policies are celebrated as landmark wins the moment they are signed into law, with little to no follow-up to measure whether they deliver on their stated goals. He cites a 2023 cross-national study of 47 recently implemented health care policies, which found that only 31% of them delivered more than half of the promised health benefits to target populations, while 22% had no measurable positive impact at all, and 8% even worsened existing health equity gaps. Samsom lays out four core metrics that should be used to judge any health care policy, regardless of its stated goals. First, health equity gap reduction: policies should be measured by how much they narrow gaps in health outcomes between low-income, racial minority, rural, and other marginalized groups and their more privileged counterparts, rather than just average population-wide improvements. Second, health care access growth: assessments should track how many additional people are able to access needed care, including primary care, specialist appointments, and essential medications, rather than just counting how many people are technically eligible for benefits. Third, financial protection: policies should be judged by how much they reduce rates of catastrophic health expenditure, defined as out-of-pocket medical costs that exceed 10% of a household’s disposable income, rather than just reported cuts to individual service fees. Fourth, system resilience: policies should be evaluated by how much they improve the health system’s ability to respond to public health emergencies, from seasonal flu outbreaks to large-scale pandemics. He uses the example of a 2018 pediatric dental care policy rolled out in a Western European country, which was widely celebrated as a major win for children’s health when it promised free dental care for all residents under the age of 12. A 2023 independent assessment found that while the policy increased dental visit rates for children in high-income urban neighborhoods by 18%, it only increased visit rates for children in low-income rural communities by 2%, as there were almost no dental clinics in those areas willing to accept the government’s low reimbursement rates for the free services. Samsom argues that this policy should be considered a failure, not a success, because it widened equity gaps rather than closing them, even though it delivered on its promise of formal eligibility for all children. He concludes by calling for all governments to establish independent, non-partisan health policy assessment bodies that publish public outcome reports every 12 months for all major health policies, with automatic triggers to adjust or defund policies that fail to meet minimum outcome thresholds after two years of implementation.