The ACT's health system is among the most expensive in the country but Canberrans have the lowest level of preventable deaths, according to a new report.
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The Grattan Institute published Orange Book 2018 - a state-by-state analysis of policy agendas - on Monday.
The report urged all states and territories to look towards Victoria, where healthcare is cheaper and more efficient, for guidance with their healthcare systems.
The report also suggested other states and territories take the ACT's lead and replace stamp duties with broad-based property taxes, finding the ACT had the country's most efficient tax system.
In the ACT each dollar of revenue raised costs the economy just 22 cents.
That is compared to NSW - which has the least efficient tax base - where each dollar of revenue raised costs the economy 30 cents.
The report said states should reform electricity markets to encourage reliability and reduce emissions - whether or not the federal government cooperates.
ACT consumers still paid the lowest rate for residential electricity, the report found.
The report showed while the ACT performed comparatively well in NAPLAN, students in the territory were making the least progress.
The proportion of ACT high achievers also dropped by 1.9 per cent in the past five years - the biggest drop in the country.
While the ACT had the lowest proportion of avoidable deaths, it had the second most costly health system per patient and the second longest median waiting time for elective procedures, at 46 days.
The report noted published data did not include waiting times to see a specialist before a patient would be placed on a waiting list, and said all states should publish that data to improve outcomes.
The report gave the ACT an "A" rating for transparency measures, which take into account policies including the requirement to publish ministerial diaries and the declaration of political donations of $1000 or more.
However the territory ranked poorly when it came to accountability - which takes into account standards for the ethical behaviour of ministers and members of parliament - receiving a "D" ranking.
The report noted the ACT was the only state or territory that did not have an anti-corruption or integrity commission.
Grattan Institute CEO John Daley said the state scorecard showed problems across states and territories were not hard to find.
“Per capita income has been flat for five years as the mining boom subsided," he said.
"State and territory governments continue to announce large infrastructure projects without doing enough homework beforehand.
"Home ownership is falling fast among the young and the poor, and homelessness is rising.
"Our schools are not keeping up with the best in the world. In most states, people are waiting longer for medical treatments. Wholesale electricity prices have increased significantly over the past few years.”
But, Mr Daley said, the report was not all bad news.
“Many worthwhile reforms have been implemented over the past decade,” he said.
“Victoria’s hospitals cost less per patient and contribute to better health outcomes than elsewhere.
"The ACT has started to replace inefficient stamp duties with a much more efficient broad-based property tax.
"NSW has used the good times to improve its budget position. Victoria, South Australia and the ACT have all increased the transparency of political decision-making and tightened controls over money in politics.”
