The U.S. healthcare system is lagging further and further behind other industrialized countries on major measures of quality, efficiency and access to care, according to a new report from the nonprofit Commonwealth Fund, a leading health policy foundation.

That is having a profound effect on overall health in the U.S., the report found.

In 2006-07, the U.S. recorded 96 preventable deaths per 100,000 people. By comparison, France, with the best performing healthcare system, recorded just 55 deaths per 100,000.

And while the U.S. improved between 1997-98 and 2006-07, other countries made more progress. Ireland and Great Britain, which had higher mortality rates than the U.S., now have lower rates.

“We are slipping behind,” said Commonwealth Fund Senior Vice President Cathy Schoen, one of the report’s authors.

The poor outcomes reflect the widespread problems that millions of Americans have getting access to health insurance and healthcare, the authors found.

In 2010, 44% of adults in the U.S. ages 19-64 either did not have insurance at some point during the year or did not have adequate insurance to cover their needs, up from 35% in 2003.

And a third of adults did not get medical care, did not fill a prescription, or skipped a needed test or treatment because of cost.

In Great Britain, just 5% of adults reported such an access problem.

Despite the problems with access and quality, however, the U.S,. continues to spend far more than other industrialized nations  on healthcare, with per-capita spending on healthcare now topping $8,000 a year, more than twice what most other industrialized countries spend.

One bright spot in the report is evidence that Americans with some chronic conditions such as diabetes and high blood pressure are better managing their diseases, which the authors credited to increased effort to highlight these issues.

Schoen also noted a “sea change” in hospital quality, which also reflects an intense campaign in recent years to measure quality and get hospitals to reduce events such as hospital-acquired infections.

The report’s authors concluded that the new healthcare law would likely have a major effect on many of the measurements, pushing up access to care as more people get insurance and improving outcomes as quality initiatives in the law begin to have an effect.

“We know the Affordable Care Act is going to make a difference,” Schoen said.