Despite having the costliest health care system in the world, the United States ranks last compared with five other affluent countries on measures of quality, access, efficiency, equity, and outcomes, according to a Commonwealth Fund report that analyzes international health policy surveys.

The United States did do well on some preventive care measures.

"The United States stands out as the only nation in these studies that does not ensure access to health care through universal coverage," says Commonwealth Fund President Karen Davis.

She says that the poor showing is the result of a failure to "ensure health insurance for all and encourage stable, long-term ties between physicians and their patients."

Health care systems in Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States were surveyed between 2004 and 2006. Findings were published in Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care.

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