Universal Health could have saved more than 330,000 lives in the U.S. during the time of COVID

Americans spend more on health care than people in any other country. However, in any given year, the fragmented nature of American health insurance can lead to preventable deaths and unnecessary costs. Not surprisingly, COVID-19 only exacerbated this serious public health problem, as evidenced by the high mortality rate in the U.S. compared to other high-income countries.

A new study quantifies the severity of the pandemic’s impact on Americans without health insurance. According to findings released Monday Proceedings of the National Academy of Sciences of the United States, from the outbreak of the pandemic until mid-March 2022, universal health care could save more than 338,000 lives from COVID-19 alone. The U.S. could also save $ 105.6 billion in health care costs associated with hospitalization for the disease, in addition to the $ 438 billion that could be saved in a non-pandemic year.

“Health care reform is long overdue in the United States,” said Alison Galvan, lead author of the Yale Public Health Model of Infectious Disease Modeling and Analysis. “Americans are wasting their lives and money.”

People who are uninsured usually do not have a primary care physician, which means they are more likely to prevent diseases such as type 2 diabetes. They tend to wait longer to see a doctor when they get sick. Both of these factors contribute to higher mortality rates in non-pandemic years, and have increased the impact of COVID-19. Comorbidities increase the risk of getting sick, and waiting for attention increases the chances of transmitting it to other people.

Prior to the pandemic, 28 million American adults had no insurance, and an additional nine million lost their insurance as a result of unemployment as a result of COVID-19. “A lot of Americans feel confident about having good health insurance for their employer, but employer-based insurance can be cut when it is most needed,” Galvani said.

In the new study, Galvani’s team compared the death risks of COVID-19 among uninsured people, as well as the risks of all other causes of death. The researchers collected the characteristics of the population of all Americans without pandemic insurance, taking into account things like age-specific life expectancy and an increase in mortality associated with lack of insurance. A total of 131,438 people were estimated to be saved from death as a result of COVID in 2020 alone. And as a result of COVID-19, 200,000 more deaths could have been prevented since then, bringing the total to more than 338,000 by March 12, 2022.

The researchers also calculated the cost of insuring the entire American population, and the savings that such a measure would bring. They saw that a single-payer healthcare system would save in three ways: more effective investment in preventive care, reduced administrative costs, and increased bargaining power in pharmacies, equipment, and fees. That would ultimately lead to net savings of $ 459 billion in 2020 and a pandemic year of $ 438 billion, the authors found. “Medicare for all would be an economic boost to our health care system and a life-saving transformation,” says Galvan. “It will cost people a lot less than the situation.”

The findings of Galvan and his colleagues are “very convincing,” and “I think the methodology is perfectly appropriate,” says Robert Reich, a professor of public policy at the University of California, Berkeley, who was not involved in the work. “The savings estimates are consistent with all the other estimates I’ve seen.”

Ann Keller, also an associate professor of health policy and management at UC Berkeley, suspects, however, that new research suggests underestimating preventable deaths through universal health care because it often ignores lower rates of chronic disease. supported by single-payer systems. “Consistent access to care can prevent chronic illnesses from occurring and ensure that patients who develop chronic illness are better managed,” says Keller, who was not involved in the study. “I would think that if someone were to take that into account, the estimated number of deaths avoided would be greater than the numbers indicated here.”

Whatever the exact figures, Galvani says the message from the new study is clear: “Universal single-payer health care is economically responsible and morally essential.”

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