Universal Health Care could have saved more than 330,000 lives in the United States during COVID

Americans spend more on health care than people in any other nation. Yet, each year, the partial nature of the American health insurance system causes many preventable deaths and unnecessary costs. Not surprisingly, COVID-19 has only exacerbated this already serious public health problem, as evidenced by increased mortality in the United States compared to other high-income countries.

A new study quantifies the severity of the pandemic impact on Americans who did not have access to health insurance. According to the findings published on Monday in Proceedings of the National Academy of Sciences USA, from the beginning of the pandemic to mid-March 2022, universal health care could have saved more than 338,000 lives from COVID-19 alone. The United States could also save $ 105.6 billion in health care costs associated with hospitalizations from the disease – in addition to the expected $ 438 billion that could be saved in a year without a pandemic.

“US health care reform is long overdue,” said lead author Alison Galvani, director of the Center for Infectious Disease Modeling and Analysis at Yale School of Public Health. “Americans are losing lives and money unnecessarily.

People who do not have insurance usually do not have a primary care physician, which means they are more likely to suffer from preventable diseases such as type 2 diabetes. They also tend to wait longer to see a doctor when get sick. These two factors are already contributing to higher mortality rates in pandemic-free years and complicating the impact of COVID-19. Concomitant illnesses exacerbate the risk of the disease, and waiting to seek help increases the likelihood of transmission to others.

Prior to the pandemic, 28 million American adults were uninsured, and another nine million lost their unemployment benefits due to COVID-19. “Many Americans feel confident that they have good health insurance from their employer, but employer-based insurance can be discontinued when it is most needed,” Galvani said.

In the new study, the Galvani team compared the risks of death from COVID-19 among people with and without insurance, as well as their risks from all other causes of death. Researchers compiled population characteristics of all uninsured Americans during the pandemic, taking into account things such as age-specific life expectancy and rising mortality due to lack of insurance. They estimated that a total of 131,438 people could be saved from death by COVID in 2020 alone. And more than 200,000 additional deaths from COVID-19 could have been prevented since then, reaching a total of 12 March 2022 over 338,000.

Researchers also estimated the cost of insuring the entire American population – and the savings that this measure will bring. They found that a single-pay healthcare system would generate savings in three ways: more efficient investment in preventive care, lower administrative costs and increased negotiating power for pharmaceuticals, equipment and fees. This will ultimately lead to net savings of $ 459 billion in 2020 and $ 438 billion a year without a pandemic, the authors found. “Medicare for all would be both an economic stimulus and a life-saving transformation of our healthcare system,” says Galvani. “It will cost people much less than the status quo.”

Galvani and her colleagues’ findings are “very convincing” and “the methodology seems completely correct to me,” said Robert Reich, a professor of public policy at the University of California, Berkeley, who was not involved. “The savings forecasts are in line with every other estimate I’ve seen.”

However, Ann Keller, an associate professor of health policy and management at the University of California, Berkeley, suspects that the new study may underestimate deaths that could have been avoided through universal health care because it does not take into account lower levels of chronic disease. which often accompany single-payer systems. “Having constant access to care can prevent the onset of chronic diseases and can ensure that patients who develop chronic disease are better managed,” said Keller, who was also not involved in the study. “I think that if this is taken into account, the estimates of avoided deaths will be higher than the numbers reported here.

Whatever the exact figures, Galvani says the message from the new study is clear: “Universal health care with one payer is both economically responsible and morally necessary.”

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