Universal healthcare as pandemic preparedness: The lives and costs that could have been saved during the COVID-19 pandemic
- PMID: 35696578
- PMCID: PMC9231482
- DOI: 10.1073/pnas.2200536119
Universal healthcare as pandemic preparedness: The lives and costs that could have been saved during the COVID-19 pandemic
Abstract
The fragmented and inefficient healthcare system in the United States leads to many preventable deaths and unnecessary costs every year. During a pandemic, the lives saved and economic benefits of a single-payer universal healthcare system relative to the status quo would be even greater. 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. Universal healthcare would alleviate the mortality caused by the confluence of these factors. 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 nonpandemic mortality, we estimated that a single-payer universal healthcare system would have saved about 212,000 lives in 2020 alone. We also calculated that US$105.6 billion of medical expenses associated with COVID-19 hospitalization could have been averted by a single-payer universal healthcare system over the course of the pandemic. These economic benefits are in addition to US$438 billion expected to be saved by single-payer universal healthcare during a nonpandemic year.
Keywords: costs saved; lives saved; pandemic preparedness; universal healthcare.
Conflict of interest statement
The authors declare no competing interest.
Figures

Comment in
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Universal healthcare and the pandemic mortality gap.Proc Natl Acad Sci U S A. 2022 Jul 19;119(29):e2208032119. doi: 10.1073/pnas.2208032119. Epub 2022 Jul 12. Proc Natl Acad Sci U S A. 2022. PMID: 35858368 Free PMC article. No abstract available.
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