Despite outspending its high-income counterparts on health care, America trails behind in key health indicators, including life expectancy and chronic disease prevalence.

That’s according to a new comprehensive study released by The Commonwealth Fund, an independent research organization, and it highlights a concerning paradox within the American health care system. While health care expenditure in America far exceeds that of other wealthy nations, Americans face lower life expectancies at birth and the highest incidence of multiple chronic conditions.

“Americans are living shorter, less healthy lives because our health system is not working as well as it could be,” the report’s lead author, Munira Gunja, senior researcher for The Commonwealth Fund’s International Program in Health Policy and Practice Innovation, said in a press release.

“To catch up with other high-income countries,” she added, “the administration and Congress would have to expand access to health care, act aggressively to control costs, and invest in health equity and social services we know can lead to a healthier population.”

Furthermore, the study details the America’s position at the top of an undesirable list, with the highest rates of avoidable deaths, maternal mortality, and infant mortality when compared against countries like Australia, Canada, France, Germany, Japan, the Netherlands, New Zealand, Norway, South Korea, Sweden, Switzerland, and the United Kingdom.

One striking finding from the report is the relative scarcity of medical consultations in the United States, attributed to a lower-than-average number of practicing physicians. This issue is exacerbated by the lack of universal health coverage — a feature that distinguishes the United States from all other nations examined in the study. In 2021, 8.6 percent of Americans lacked health insurance.

“Not only is the U.S. the only country we studied that does not have universal health coverage, but its health system can seem designed to discourage people from using services,” researchers at the Commonwealth Fund, headquartered in New York, wrote in the report.

“Affordability remains the top reason why some Americans do not sign up for health coverage,” the researchers added, “while high out-of-pocket costs lead nearly half of working-age adults to skip or delay getting needed care.”