Epidemiologists from the Yale School of Public Health, University of Florida, and University of Maryland School of Medicine, have calculated that a single-payer universal health-care system in the US would likely lead to a 13 percent saving in national health-care expenditure and prevent more than 68,000 unnecessary deaths. By replacing premiums, deductibles, co-payments and out-of-pocket costs with a progressive tax system, Medicare for All will not only save the average family around $2,400 a year, but also give lower-income families access to the services they need, the researchers say.
Published in The Lancet, the study first sets out the current state of affairs. Over 78 million Americans (24 percent of the US population), do not have adequate access to care. This number includes over 37 million Americans who have no health insurance at all. However, the situation could get worse. “The move to repeal the Affordable Care Act by the Trump administration will further jeopardize the health care of 21 million Americans,” the researchers warned in the paper, which would “exacerbate health-care inequities.”
Already the USA ranks poorly for many public health indicators, such as preventable deaths, infant survival, and maternal mortality, given its national health expenditure is higher than any other country. Repealing the Affordable Care Act would result in an additional loss of more than 38,500 lives, the team writes in their paper. However, employing the Medicare for All Act would save over 68,500 lives, compared to the status quo.
This life-saving effect that the Medicare for All Act would achieve is calculated from just one group of people: those that are uninsured. In this group, people are reported to experience a 40 percent elevation in age-specific mortality risk. If all Americans became insured, the universal coverage would save tens of thousands of lives, and around 1.73 million life-years annually.
Accompanying the paper is an interactive tool, called the Single-Payer Healthcare Interactive Financing Tool (SHIFT). Here, the economics of the Medicare for All Act can be analyzed using a number of parameters involving the health-care budget, expansion in service use, and revenue generation. Across a wide range of assumptions, projections from SHIFT indicate net savings for the health-care system. In the researchers' base case the savings would include $59 billion on hospital care, $23 billion on physician and clinical services, $217 billion on overheads and $177 billion on prescription drugs.
Previous objections to Medicare for All based on the expectation of rising costs are mistaken, write the authors. Although further opposition from health insurance and pharmaceutical industries should be expected, the authors believe that “the moral imperative to provide health care as a human right, not dependent on employment or affluence,” should counterbalance any concerns.
Lead author of the study Professor Alison Galvani shared a clip of Democrat presidential nominee candidate Bernie Sanders discussing the paper in Carson City, Nevada at the weekend on Twitter.