It may come as surprise that a country so rich in natural resources and adventure activities ranks 21st overall, below Belgium and Denmark. The US score suffers in the "health" and "humanitarian" pillars. The country has fewer physicians and beds per 10000 people than other developed countries. it is worth noting here that the ATDI does not measure quality of health services, rather the index uses the hard data available from the World Health Organization or from the country itself. The US humanitarian score is also low, indicating a low density and presence of NGOs. So, although in 2010 the US gained 13 points in the "Readiness" category, its other scores were stable year over year and overall, it underperformed compared to other developed nations. Although state governments are often active in promoting tourism, there is a significant lack of attention from the national government-unlike most countries, the US does not have a designated agency responsible for tourism development and promotion. However, this may be changing. In 2010, the Travel Promotion Act was signed. This legislation calls for an overseas travel promotion program which the US projects could yield millions of new visitors, $4 billion in new economic stimulus,40000 new American jobs,and $320 million in new federal tax revenue. The Congressional Budget Office reports that the bill will reduce the deficit by $425 million and increase revenues by $135 million over the next 10 years. The bill is funded by a $10 fee paid by overseas visitors to the United States and matching funds from the US private travel sector.