A report from The Commonwealth Fund reveals that the United States ranks last among 10 developed countries in overall health care performance, despite spending the most on health care. Americans have the shortest life expectancy and highest rates of avoidable deaths, with significant barriers to accessing care and lower health equity. The U.S. health system is inefficient, with heavy administrative burdens and fragmented insurance processes. In contrast, Australia, the Netherlands, and the United Kingdom rank highest due to their nationalized health care systems, which streamline care and reduce costs. The U.S. did rank second in preventive care and patient engagement, partly due to the Affordable Care Act. The findings underscore the urgent need for systemic reforms to improve equity, access, and efficiency in the U.S. health care system.