There is much to blame for the poor performance of the Covid-19 pandemic in the United States, from the highly contagious virus to the slow response of the Trump administration to the deep gaps in U.S. politics and culture. But a new study by a group of researchers at Yale and UMass-Amherst says the U.S. has suffered more deaths than most economic members of the population as a result of something more specific: a lack of universal health care.
According to that newspaper published this month PNAS, at least 212,000 fewer Americans would die as a result of Covid-19 alone in 2020 if the U.S. had a single-payer health care system similar to the Medicare-for-all plan proposed by Senator Bernie Sanders (I-VT). The country would save $ 105 billion on pandemic-related health care spending.
Researchers have looked at different factors that would reduce the number of Covid-19 deaths in a system that the government insures all of and pays for almost all health care costs:
- No one would lose health insurance because of the economic pandemic caused by the loss of employment. (Research estimates that about 14.5 million Americans lost their employer coverage in March and April 2020, although some of these people may be covered by Medicaid). . More insured people would lead to more cases being diagnosed and treated sooner, reducing the likelihood of serious illness or death.
- Vaccination rates would probably be higher — and therefore less serious and less fatal — if more Americans had contact with a primary care physician who is not one of four people in the U.S..
- And by reducing the number of Covid-19 hospitalizations through more vaccinations and early diagnoses, U.S. hospitals would have less strain. This will make it easier for them to manage all their patients, rather than the situation last summer – when vaccines became widely available – when people showed up in treatment rooms or staffless hospitals to treat them. Some of these people were killed.
The logic of the paper’s conclusions makes sense. I wrote in the middle of the spring of 2020 that all the problems of the broken American health care system were being fully exposed for failing to respond properly to Covid-19. And if you look at the countries with a universal health care system (the United Kingdom, Taiwan, Australia, and the Netherlands, the countries we’ve covered in our Everybody Covered universal health care series, as well as France and Germany), they’ve had fewer deaths each. Population than the US.
All of these countries have universal health care, but not all of them have a single-payer system in line with Sanders’ Medicare-for-all proposal. Taiwanese yes. But Australia uses a hybrid program where some people are dependent on public health insurance and others use private plans. The Netherlands and Germany rely on private health insurance, which is highly regulated and subsidized by the government. The UK National Health Service goes beyond a single payer and is fully socialized: the government pays for all care, runs hospitals and employs doctors directly.
Countries with universal health care were overtaken by the US in the pandemic – part of the role of the paper is undisputed. But they have rolled out different programs to achieve this goal. It is not clear to me that Medicare-for-all would necessarily lead to better outcomes, such as the Australian or Dutch approach model.
There may be other factors at stake beyond the specific type of health care system. As Damien Cave wrote for the New York Times in Australia, it seems that social trust was a crucial difference between the American and Australian experiences during the pandemic. The two nations share a lot of sociocultural DNA, but Aussians have more confidence in the people in general, and in their health care system in particular, than the Americans, Cave wrote. While I was reporting on South Korea’s successful Covid-19 response, Korean sources to some extent stated that the people there have a high level of trust in the government.
This also makes intuitive sense. As a result, people in more confident societies would be more likely to wear masks or stay at home or be vaccinated not only for their own benefit, but also for the health of the people around them and society.
In a way, social trust and universal health care are one and the same thing: a society’s willingness to come together and care for each other. The US does not have the same culture of collective responsibility as these other wealthy nations. This lack of social cohesion is reflected in the failure to comply with public health measures and the failure to build a health care system that will take care of us all.
Universal health care is an option that reflects the values of a country. While reporting on the Everybody Covered series, I came across this quote from Uwe Reinhardt of Princeton Health. It was in his last book pricePublished after his death in 2017:
Canada and almost all developed nations in Europe and Asia have, for decades, reached a political consensus to treat health care as a social good.
In contrast, in the United States we have never reached a politically dominant consensus on the issue.
While traveling in Taiwan or the Netherlands, people were asking me about U.S. health care and I should say that millions of Americans were uninsured and could charge people thousands of dollars for medical care. That was incomprehensible to the people I met. They lived in a country where people agreed that such things should never be allowed to happen.
America has never made such a collective commitment to providing health care to all. The country paid the price for this myopia during the pandemic, as this new study helps prove. Whatever form it took, a universal health care system would probably have prevented tens of thousands of deaths as a result of the novel coronavirus.
It’s too late now.