Study states universal health care could have saved more than 200,000 lives during the pandemic in 2020 alone

More than a million people have died from COVID-19 in the United States since the beginning of the pandemic. A new study published in the Proceedings of the National Academy of Sciences USA (PNAS) journal claims that 212,000 of these lives could've been saved in 2020 alone if the nation had a single-payer healthcare system similar to the Medicare-for-all plan proposed by Sen. Bernie Sanders. The study conducted by a group of scholars at Yale and UMass Amherst also found that the country would have saved $105 billion in pandemic-related healthcare costs if it had universal healthcare.

"Health care reform is long overdue in the U.S. Americans are needlessly losing lives and money," said the study's lead author and director of the Center for Infectious Disease Modeling and Analysis at the Yale School of Public Health, Alison Galvani, reports Scientific American. Given the nation's fragmented healthcare system, millions of Americans lean on private marketplace plans and employer-sponsored coverage. However, more than 9 million Americans lost their insurance when they fell into unemployment during the pandemic. "Many Americans feel secure in having good health insurance from their employer, but employer-based insurance can be cut off when it is needed most," Galvani pointed out.

In the new study, researchers compared mortality statistics to national insurance enrollment rates to determine how the absence of consistent health insurance caused elevated fatality rates. They found that while insurance enrollment from December 2019 to April 2020 experienced a 14.5 million drop in employer-sponsored insurance plans, Medicaid enrollments rose from 71.6 million in March 2020 to 80.2 million in December 2020. The researchers noted that the increase in Medicaid enrollment could have been a response to the student rise in unemployment rates, the result of ongoing Medicaid expansion efforts or due to the perceived risk of COVID-19.

By comparing statistics to mortality data, the researchers arrived at the conclusion that 26.4 percent of the lives that were reported to be lost due to COVID-19 would likely have been saved if the U.S. had universal healthcare throughout the pandemic. "For Americans who are uninsured and underinsured, financial barriers to COVID-19 care delayed diagnosis and exacerbated transmission. Concurrently, deaths beyond COVID-19 accrued from the background rate of uninsurance," the study states. "To evaluate the repercussions of incomplete insurance coverage in 2020, we calculated the elevated mortality attributable to the loss of employer-sponsored insurance and to background rates of uninsurance, summing with the increased COVID-19 mortality due to low insurance coverage."

"Incorporating the demography of the uninsured with age-specific COVID-19 and non-pandemic mortality, we estimated that a single-payer universal healthcare system would have saved about 212,000 lives in 2020 alone," it adds. The researchers also estimated the cost to insure the entire American population and found that a single-payer healthcare system would generate savings by giving way to more efficient investments in preventative care, lowered administrative costs and increased negotiating power for pharmaceuticals, equipment and fees.

Ultimately, this would generate a net savings of $459 billion in 2020 and $438 billion in a nonpandemic year, the study reports. "Medicare for All would be both an economic stimulus and life-saving transformation of our health care system," said Galvani. "It will cost people far less than the status quo." Robert Reich, a professor of public policy at the University of California, Berkeley—who was not involved in the work—confirmed that findings of the study were "very convincing" and "the methodology strikes me as exactly right."

However, Ann Keller—an associate professor of health policy and management, also at U.C. Berkeley—suspects that the study may have underestimated the deaths that could have been avoided through universal health care as it does not factor in the lower rates of chronic disease that often accompany single-payer systems. "Having consistent access to care can prevent chronic disease from occurring and can ensure that patients who develop chronic disease have it better managed," said Keller, who was also not involved with the research. "I would think that, if one took that into account, the estimates of avoided deaths would be greater than the numbers reported here." Irrespective of the number, Galvani says that the study's message is clear: "Universal single-payer health care is both economically responsible and morally imperative."