As the editors at WalletHub point out, given the U.S. spends $2.9 trillion a year on health care — double per capita compared to other industrialized nations — one would assume the United States is home to the healthiest human beings. But somehow the opposite is true: Americans have shorter lives, higher infant mortality rates and more chronic diseases than citizens of almost all other rich countries.

There are a number of reasons for this truly shameful situation, including the fact that the U.S. by far outspends other nations on medical research. But the undeniable main reason we spend so much on health care in the U.S. and get so little return is a highly fragmented multi-level system with way too much bureaucracy. Studies show many of the problems with the American health care system are directly related to over-regulation, poor management practices and too many greedy businesspeople trying to get their fingers into the profitable health care pie.

In order to calculate the quality of U.S. health care relative to its cost (health ROI), WalletHub took health care data from 47 states and designed a health care-related return on investment (ROI) metric. The goal is to help educate Americans on how much “bang for the health care bucks” they’re getting in their respective states.

Average U.S. health care costs

The average annual health insurance premium for an individual was $5,884 in 2013, while families coughed up an average of $16,351 to maintain group health coverage. That means that individual health care coverage has gone up by 74% and family coverage increased by 80% since 2003.

Health ROI rankings

States with best and worst health ROI

Minnesota clearly comes out on top of the state health ROI rankings with an America’s Health Ranking (AHR) ranking of 3, a Death Rate Ranking (DRR) of 2 and a Health Care Costs Ranking (HCCR) of 1. Utah was the number two ranked state, with an AHR of 6, a DRR of 15 and an HCCR of 3. Kansas was third on the state health ROI list with an AHR of 27, a DRR of 29 and an HCCR of 2.

Mississippi came in at the bottom (47th) of the state health ROI list with an AHR of 50, a DRR of 50 and an HCCR of 34. Louisiana was ranked 46th, with an AHR of 48, a DRR of 47 and a HCCR of 22. Arkansas was ranked 45th on the list, with an AHR of 49, a DRR of 45 and an HCCR of 29.