Canada has been ranked third-to-last in a detailed new study comparing health-care systems in 11 developed nations, managing to beat out only France and the bottom-ranked United States.

The study, published this week by a New York-based private research foundation called the Commonwealth Fund, focuses largely on America’s dismal performance, but also reveals stubborn weaknesses in Canada’s system that keep us lagging behind top-ranked countries like Australia, the United Kingdom and the Netherlands.

According to the study, which relies on 72 metrics grouped into five distinct categories (Care Process, Access, Administrative Efficiency, Equity, and Health Care Outcomes), those weaknesses include Canada’s comparatively higher infant mortality rate, the prevalence of chronic conditions, long wait times in emergency rooms and to see specialists, poor availability of after-hours care, and a lack of reliable coverage for things like dental work and many prescription drugs.