The Commonwealth Fund published its 2026 report card on US healthcare this week, measuring the United States against 19 other wealthy countries. It runs the most expensive system on earth, and it buys some of the worst results in the developed world. I have spent more than four decades in the medical intensive care unit at UCLA, and I do not read those numbers as statistics. I read them as the people I admit.

We spend 18% of our economy on healthcare, nearly twice the average of comparable nations, and $12,649 a person, roughly 10 times what Mexico spends. For that fortune, American life expectancy peaked at 79 years, more than two years below our peers and third from the bottom of the group, above only Mexico and Turkey. Our rate of deaths that good care should have prevented is the second worst in the developed world. Only Mexico does worse.

The report grades four areas: coverage, affordability, the delivery of care, and equity. We fail or nearly fail each one. We and Mexico are the only countries studied that have never guaranteed coverage to everyone, and 27 million Americans have none. We have the fewest primary care doctors per capita. Nearly a third of the country, 100 million people, has no regular place to seek care until they are sick enough for my unit. Black women die in childbirth here at a rate........

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