Health care in U.S. is most expensive, and least effective, in the world among developed nations: Study A recent survey of the health care systems of the world's 11 wealthiest nations ranked the U.S. dead last on measures of 'efficiency, equity, and outcomes.' The U.S. also bottomed out in the same survey in 2010, 2007, 2006 and 2004. by Michael McEnaney