For five years in a row, our health care system has ranked dead last in an annual review of systems across 11 industrialized nations.

Shocked? Perhaps not, but there are some particularly frustrating points worth noting.

Of the five overall categories with rankings, the U.S. placed last in three, including efficiency, equity, and healthy lives. Under access, where we ranked ninth overall, we place last for cost-related problems to access.

Oh, and we have the highest health expenditures per capita, by a long shot – we’re at $8,508 while the next most expensive is Norway at $5,669. The number one overall ranking went to the United Kingdom, where health expenditures per capita are $3,405.

So what does this mean for consumers? Our system is designed in such a way that care is inequitable, inefficient and so expensive that it creates significant barriers to access. As a result, we’re less healthy than other industrialized countries, and we’re spending at least 50% more to be the sickest.

To be fair, the data used for the newest survey was collected before full implementation of the Affordable Care Act (ACA). In Washington state, we’ve already seen tremendous numbers of people signing up for new coverage, particularly through Medicaid expansion. But we don’t really know much else. Only time will tell whether people stay covered, and whether coverage options are truly affordable and of the quality that most workers and families expect to receive when shelling out thousands of dollars every year.

The ACA is one of the crowning achievements of the Obama administration, but most in favor of health reform would agree that too many concessions were made in the political process. And it’s much too soon to tell exactly where the ACA is most and least successful. So how do we continue to push forward health reform while everyone holds their breath, watching and waiting for ACA outcomes?

Our best option is to continue to push for further reforms at the state level. Washington has a history of being a leader in health care, and we have a track record of passing innovative policies. There is much more to be done, and we cannot simply wait until data and research are released in the years to come.

There are many for whom coverage remains inaccessible, and it’s disgraceful to expect them to continue to suffer from poor health because the ACA is the best we can do for now. Quality, affordable coverage certainly isn’t going to happen by the good intentions of legislators alone, so talk to your neighbors, meet with your elected officials, and share your story about what is isn’t working about your health care. There are paths forward (for example, the Basic Health Option), but legislators need to hear that we want, need, demand more.