American exceptionalism was — and may still be — more fact than fiction. Books have been written on it. Websites are devoted to it. Pundits debate it, wondering all the while if it’s dissipated over time.

Today, given everything the United States has going for it, there’s no reason why American health care shouldn’t be among the world’s best.

Put away any resentment for the Affordable Care Act, or Obamacare, as you may call it, and consider the facts. When compared to other nations, the United States’ overwhelming advantages in finances, facilities and human capital is virtually untouchable. So why, then, does U.S. health care rank so poorly against its industrialized peers?

That’s not a rhetorical question, but Americans today — particularly those who vehemently oppose President Obama’s health-care reform effort — mustn’t ignore reality. Health care in America is expensive and yet severely lacking in certain key areas, most notably efficiency and a lack of primary care doctors.

Those among the findings of the Commonwealth Fund, which Monday released an exhaustive study of the top 11 industrialized nations’ health-care systems. The Fund ranked the nations: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States. The United States was ranked dead last.

The top three: the United Kingdom, Switzerland and Sweden.

Commonwealth Fund researchers didn’t say U.S. health care was substandard. What it said — notice the distinction — is that U.S. health care is unevenly distributed, far too expensive when compared with peer nations, and thus ineffective as a whole.

In numbers, it looks like this. In 2011, the United States spent $8,508 per person on health care. The top-ranked United Kingdom spent $3,406.

In other words, more bang for less buck.

What we already knew was true has been confirmed: On average, Americans spend more per capita on health care than any other country. The result is a nation beset with health problems, particularly among the poor and unemployed. And Obamacare can’t solve the depths of America’s unequal access to health care overnight.

We’ve seen what happens when Washington tries to reform the U.S. health-care system. Capitol Hill erupts into a sea of lobbyists, radicals and reformers. It took a Supreme Court decision to make Obamacare the law of the land. If only the law was better than it is.

America is an exceptional place, lest we forget. That only makes the nation’s enduring struggle to take care of its citizens’ health all the more confounding.