the commonwealth fund's 2018 study of 11 countries, including australia, canada, france, the netherlands, germany, norway, sweden, switzerland, and the u.k., found that the u.s. ranked last for health outcomes. equity and quality, despite having the highest per capita health earnings, last. the study also found that more americans die from poor care quality than the citizens of any other country involved in the study. also, poor access to primary care in the u.s. has contributed to inadequate chronic disease prevention and management. delayed diagnoses and safety concerns, among other issues. much of the care accessed by americans is inadequate to their need. prices of pharmaceuticals are sky high as compared to other countries, especially for life-saving drugs such as insulin. the population of the country remains underinsured as of the -- as the political debates of different approaches sizzle in the prelude to the next election. everything has a history. that's our motto at the national history center. everything has a history. and before we can get to a better place, we need to understand how we came to this