The U.S. health-care system was among the least efficient in the developed world two years before major changes from Obamacare began to go into effect.

Americas health-care system ranked 44th of 51 nations assessed by Bloomberg, in terms of per person spending, life expectancy and health-care cost as a percentage of the economy. Its an improvement from 46th of 48 last year, yet Serbia, Turkey and China still scored better.

Singapore, with the top ranking, spent $2,426 per person and had a life expectancy of 82.1 years in 2012, the most recent year for which data are available. In comparison, the U.S. shoveled cash into health care -- $8,895 per person, per year -- and Americans are expected to live for 78.7 years.

Theres a lack of accountability among Americans, according to policy experts. We keep protecting individuals from the health-care costs that come from the fact that we dont have healthy lifestyles, Cindy Gillespie, a senior managing director at the law and policy firm McKenna Long & Aldridge LLP. We havent accepted that people have an element of personal responsibility around their health.

This year the Patient Protection and Affordable Care Act, or Obamacare, required all Americans to get health coverage. A goal of the law is to cut costs while improving Americans health.

Bloombergs ranking used life expectancy, health care as a percentage of gross domestic product and total expenditures. It assessed 51 countries with populations of at least 5 million, per capita gross domestic product of $5,000, and life expectancies of at least 70 years.

Experts have criticized life expectancy as a sole measure of health, since factors such as income and education level affect a persons health as well. The ranking is meant to employ a simple approach and life expectancy is a reflection of how well a health-care system works.

About 60 percent of Americans get insurance through work, according to the Robert Wood Johnson Foundation -- leaving many with little ability to compare coverage prices on the open market. Even if people wanted to price shop, theres little transparency about what theyre buying, since the cost of services at hospitals a few miles apart can vary by hundreds or thousands of dollars, Gillespie said.

The countries ranked the best all have some type of national health system. Singapore, Hong Kong, Italy and Japan make up the top four.

Singapores health-care spending grew 13 percent from 2011 to $2,426 per person. Spending as a percentage of GDP was constant, 4.5 percent in 2012 from 4.4 percent in 2011.

Here is the original post:

U.S. Health System Among Least Efficient Before Obamacare