More than 330,000 Americans could have been saved during COVID-19 pandemic if the United States operated under a universal health care system – nearly one-third of the total COVID-related deaths – according to a recent study.
The study, published in Proceedings of the National Academy of Sciences USA last week found that universal health care would have helped address underlying and pre-existing conditions that contributed to the COVID-related deaths, ultimately saving over 338,000 lives between the start of the pandemic and mid-March 2022.
COVID has killed more than 1 million Americans since 2020, according to Johns Hopkins University.
“People who don’t have insurance usually don’t have a primary care doctor and are more likely to suffer from preventable diseases like diabetes. Such comorbidities exacerbate risks of COVID-19 mortality,” Alison Galvani, the lead author on the study, told USA TODAY. “They also tend to wait longer to seek treatment, which further compounds death and transmission rates.”
Galvani, along with her co-authors, compared the mortality risks for people with and without insurance of COVID and other causes of deaths to determine the number of lives a universal health care system would have saved, noting that the pandemic further exasperated the United States’ “fragmented and inefficient” health care system.
“Health care reform is long overdue in the US. Americans are needlessly losing lives and money,” Galvani added. “Medicare for All would be both an economic stimulus and life-saving transformation of our health care system.”
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An "ambitious" study
Any study attempting to gauge how universal health care might have impacted the pandemic in the U.S. is "ambitious," in part because the politicization of COVID makes it difficult to predict how Americans would respond, said Mark Fendrick, a public health professor at the University of Michigan.
“Insurance doesn’t always mean access. Generous insurance, which leads to improve access, is a really good thing," Fendrick said.
But because we don't know what the benefits of a single-payer system might be in the U.S., it can lead to "broad assumptions" about how many people would access and use the health care, he said.
"Just because we might presume that people may take advantage of a free flu shot or a free mammogram if they had insurance, it's almost impossible for us to predict it would be the same for COVID because millions of Americans had access to free vaccines who didn't take it."
But the study offered a “unique twist” compared to similar studies because it used pandemic to illustrate the United States’ dysfunctional health care system, said John McDonough, a public health professor at Harvard University.
“I think the study was creative and helpful in that way, in terms of saying ‘Look, you have an important example here of the U.S. health system's dysfunction that everyone witnessed, and everyone saw,’” McDonough said. “It’s a little bit of connecting the dots exercise for folks who probably wouldn’t necessarily think that way.”
Could universal health care provide leverage to negotiate drug costs?
The study also calculated the cost of insuring all Americans under a universal single-payer system, determining that it would generate savings through efficient investments in preventative care, consolidating administrative costs and increased negotiating power over pharmaceuticals and equipment.
Since the system would be a “unified purchaser”, it would have significant negotiating power to bring down drug prices in the U.S., which can be much higher than other countries and leave many Americans unable to afford lifesaving drugs, including insulin, the study showed.
The study also estimates that a universal system would have saved the country $105.6 billion in health care costs associated with the pandemic, in addition to the $438 billion the country would save in a typical year.
The study's claims about a single-payer system's influence on drug prices are unproven and would have been less relevant during the pandemic, Fendrick said.
"When it comes to COVID, it was mostly a volume issue, not a price issue," he said.
But McDonough said Germany and other countries have systems to regulate health care costs, including pharmaceuticals.
“If there’s one purchaser of pharmaceuticals then that creates substantially more leverage," McDonough said. "Most other advanced societies have some system other than just the free, unregulated market to address the cost of prescription drugs,” McDonough added.
More coverage of COVID from USA TODAY
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COVID boosters: Patient group calls for recurring COVID-19 boosters to cut through vaccine apathy
Long COVID: 'That’s just part of aging': Long-COVID symptoms are often overlooked in seniors
COVID treatments: Effective treatments for COVID are now available. Why are they not being used?
'We can’t do this on our own': Small hospitals are left behind by COVID staffing wars
This article originally appeared on USA TODAY: Lack of universal health care cost 300,000 US lives in COVID: study
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