People in the United States die the earliest and live the sickest lives out of 10 developed countries, even though the United States spends the most on healthcare, a new report says.

A new report from The Commonwealth Fund found that the U.S. had the worst-performing healthcare system overall despite spending nearly double that of other countries.

The US spends more on health care than any other high-income country, but a new report suggests that “Americans are sicker, die younger and struggle to afford essential health care.”