The Commonwealth Fund is a private U.S. foundation whose stated purpose is to "promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, and people of color." It is active in a number of areas related to health care and health policy. It is led by David Blumenthal, M.D. Healthcare rankings Since 2004 it has produced reports comparing healthcare systems in high income countries using survey and administrative data from the Organisation for Economic Co-operation and Development and the World Health Organization which is analyzed under five themes: access to care, the care process, administrative efficiency, equity and health-care outcomes. The United States has been assessed as worst health-care system overall among 11 high-income countries in every report, even though it spends the highest proportion of its gross domestic product on health care. In 2021 Norway, the Netherlands and Australia were the top-performing countries. Founding and early program history The Commonwealth Fund, one of the first foundations to be established by a woman, was founded in 1918 with an endowment of almost $10 million by Anna M. Harkness. The widow of Stephen V. Harkness, a principal investor in Standard Oil, Mrs. Harkness wanted to “do something for the welfare of mankind.” Anna's son, Edward Stephen Harkness, became the Commonwealth Fund's first president and hired a staff of people to help him build the foundation. Edward Harkness possessed a "passionate commitment to social reform" and was "determined to improve health and health services for Americans." Through additional gifts and bequests between 1918 and 1959, the Harkness family's total contribution to the fund's endowment amounted to more than $53 million. By the end of 2021 the Commonwealth Fund's endowment stands at almost $840 million. According to the Rockefeller Archive Center, the Commonwealth Fund's “early grants supported a variety of programs while generally promoting welfare, especially child welfare.” Over the years, it has given support to medical schools and to the building of hospitals and clinics. In New York City, the Commonwealth Fund and Edward Harness largely orchestrated the merger of Columbia Medical School and Presbyterian Hospital. The merger culminated in the construction of the worlds first academic medical center then-called Columbia-Presbyterian Medical Center of the in 1922. The Hospital continues to operate today as NewYork-Presbyterian / Columbia University Irving Medical Center which contains the Harkness Pavillion and