A new report from the Commonwealth Fund, a private research and advocacy foundation, analyzed different countries' healthcare systems and ranked the U.S. worst among 10 nations overall.

The report compared Australia, Canada, France, Germany, The Netherlands, New Zealand, Sweden, Switzerland, the UK, and the U.S. Australia ranked the top overall. The U.S. was at the bottom for access to care and health outcomes.

The report was based on data that included international population and physician surveys from 2021, 2022, and 2023; plus the World Health Organization, Our World in Data, national data registries and published research.

The U.S. came in second to last in rankings of equal care and how efficient the administrative process is.

Experts say one issue with the U.S. health care system is the complexity of insurance. There's a variety of insurance plans with different requirements, which impacts how providers get paid and how the patient's bill is paid for.

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"That leads to denials of service. It leads to the bargaining that goes on between doctors and hospitals and insurance companies and between patients and insurance companies. It leads to prior authorization and disapproval of ordered services," Dr. David Blumenthal, former Commonwealth Fund president, told reporters in a media briefing. “The United States lags both in having 20 plus million Americans still uninsured. 70% of the population, though a historic low, still very high by international standards. And it also lacks in terms of the ability of lower income people to get access to basic services.”

The U.S. did rank high in some metrics, coming in second for care processes. That includes things like preventive care and patient engagement.

Read the full report here.