- What's Actually Wrong With the U.S. Health System: On the heels of the Senate’s latest attempt at replacing the Affordable Care Act, the Commonwealth Fund has released its latest evaluation of what exactly ails the U.S. health care system. Once again, the researchers found the U.S. medical system performed the worst among 11 similar countries, all while spending more. The United States fared especially badly on measures of affordability, access, health outcomes, and equality between the rich and poor. The United Kingdom ranked first, and the other countries in the comparison were Australia, Switzerland, Sweden, the Netherlands, New Zealand, Norway, Germany, Canada, and France.