Improving the Prognosis of Healthcare in the United States

Although healthcare expenditure per capita is higher for the United States than any other country, over 37 million Americans are entirely without health insurance and 41 million more have inadequate access to care. Whereas ongoing efforts to repeal the Affordable Care Act would exacerbate healthcare inequities, a universal system, such as that proposed in the Medicare for All Act (MAA), has the potential to transform the availability and efficiency of American healthcare. Taking into account both the costs of coverage expansion as well as savings that would be achieved through the MAA, we calculate that a single-payer, universal healthcare system is likely to lead to a 13% savings in national healthcare expenditure, equivalent to over $450 billion annually. The entire system could be funded with less financial outlay than is currently incurred by employers and households through healthcare premiums, as well as existing government allocations. This shift to single-payer healthcare would provide the greatest relief to lower-income households. Furthermore, we estimate that ensuring healthcare access for all Americans would save over 68,000 lives and 1.73 million life-years every year.

[1]  P. Borzi,et al.  Centers for Medicare and Medicaid Services , 2020, Definitions.

[2]  D. McCarty,et al.  Comparing Canadian and United States opioid agonist therapy policies. , 2019, The International journal on drug policy.

[3]  L. Lapinski.  Book Review: Organisation for Economic Co-operation Development , 2019, Journal of Technology Education.

[4]  Alex Hollingsworth,et al.  Simulated Power Analyses for Observational Studies: An Application to the Affordable Care Act Medicaid Expansion , 2019 .

[5]  P. Sorum.  Why Internists Might Want Single-Payer Health Care , 2018, Annals of Internal Medicine.

[6]  W. Schaffner,et al.  Why Internists Might Want Single-Payer Health Care , 2018, Annals of Internal Medicine.

[7]  Charles P. Blahous.  The Costs of a National Single-Payer Healthcare System , 2018 .

[8]  Haiqun Lin,et al.  Hospital variation in cost of childbirth and contributing factors: a cross‐sectional study , 2018, BJOG : an international journal of obstetrics and gynaecology.

[9]  Alexander J Mainor,et al.  Payer Type and Low‐Value Care: Comparing Choosing Wisely Services across Commercial and Medicare Populations , 2018, Health services research.

[10]  G. Cuckler,et al.  National Health Expenditure Projections, 2017-26: Despite Uncertainty, Fundamentals Primarily Drive Spending Growth. , 2018, Health affairs.

[11]  Michael Mueller,et al.  How much do OECD countries spend on prevention , 2017 .

[12]  D. Mauricio,et al.  Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus. , 2017, The Cochrane database of systematic reviews.

[13]  S. Friedlander,et al.  Regional variations in outcomes and cost of appendectomy in the United States. , 2017, The Journal of surgical research.

[14]  S. Vermund,et al.  California Universal Health Care Bill: an economic stimulus and life-saving proposal , 2017, The Lancet.

[15]  D. Himmelstein,et al.  The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly? , 2017, Annals of Internal Medicine.

[16]  Eyal Oren,et al.  Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015 , 2017, The Lancet.

[17]  B. Sommers.  State Medicaid Expansions and Mortality, Revisited: A Cost-Benefit Analysis , 2017, American Journal of Health Economics.

[18]  Jeffrey A Linder,et al.  Low-Value Medical Services in the Safety-Net Population , 2017, JAMA internal medicine.

[19]  Alan M Zaslavsky,et al.  Variation in Physician Spending and Association With Patient Outcomes , 2017, JAMA internal medicine.

[20]  D. Himmelstein,et al.  Single-Payer Reform: The Only Way to Fulfill the President's Pledge of More Coverage, Better Benefits, and Lower Costs , 2017, Annals of Internal Medicine..

[21]  F. Gany,et al.  Women With Breast Cancer Who Work For Accommodating Employers More Likely To Retain Jobs After Treatment. , 2017, Health affairs.

[22]  J. Rizzo,et al.  Lost Labor Productivity Costs of Prostate Cancer to Patients and Their Spouses: Evidence From US National Survey Data , 2016, Journal of occupational and environmental medicine.

[23]  Amitabh Chandra,et al.  What Does a Deductible Do? The Impact of Cost-Sharing on Health Care Prices, Quantities, and Spending Dynamics , 2015 .

[24]  R. Kaestner.  Changes in Mortality After Massachusetts Health Care Reform , 2015, Annals of Internal Medicine.

[25]  Peter Kreiner,et al.  The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction. , 2015, Annual review of public health.

[26]  Ashish Arora,et al.  Killing the Golden Goose? The Decline of Science in Corporate R&D , 2015 .

[27]  A. Weiss,et al.  Characteristics of Medicaid and Uninsured Hospitalizations, 2012 , 2014 .

[28]  Ming-Hui Chen,et al.  Cancer-specific outcomes among young adults without health insurance. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[29]  T. Coughlin.  Uncompensated Care for the Uninsured in 2013: A Detailed Examination , 2014 .

[30]  R. Hsia,et al.  Analysis of variation in charges and prices paid for vaginal and caesarean section births: a cross-sectional study , 2014, BMJ Open.

[31]  P. Hogan,et al.  Economic Costs of Diabetes in the U.S. in 2012 , 2013, Diabetes Care.

[32]  D. Heffernan,et al.  Undiagnosed medical comorbidities in the uninsured: A significant predictor of mortality following trauma , 2012, The journal of trauma and acute care surgery.

[33]  Shah Ebrahim,et al.  European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (Version 2012) , 2012, International Journal of Behavioral Medicine.

[34]  M. Roberts,et al.  Cost-Effectiveness of Different Screening Strategies for Osteoporosis in Postmenopausal Women , 2011, Annals of Internal Medicine.

[35]  W. Hsiao,et al.  What other states can learn from Vermont's bold experiment: embracing a single-payer health care financing system. , 2011, Health affairs.

[36]  A. Frakt,et al.  Should Medicare Adopt the Veterans Health Administration Formulary? , 2011, Health economics.

[37]  D. McCormick,et al.  Health insurance and mortality in US adults. , 2009, American journal of public health.

[38]  R. Kronick.  Health insurance coverage and mortality revisited. , 2009, Health services research.

[39]  N. Sood,et al.  Innovation and The Welfare Effects of Public Drug Insurance. , 2009, Journal of public economics.

[40]  H. Cannon.  MedPAC Releases March 2008 Report to the Congress: Medicare Payment Policy , 2008 .

[41]  A. Zaslavsky,et al.  Health of previously uninsured adults after acquiring Medicare coverage. , 2007, JAMA.

[42]  W. Hsiao,et al.  Does universal health insurance make health care unaffordable? Lessons from Taiwan. , 2003, Health affairs.

[43]  P. Sorlie,et al.  Mortality in the uninsured compared with that in persons with public and private health insurance. , 1994, Archives of internal medicine.

[44]  M. Gold,et al.  Health Insurance and Mortality: Evidence From a National Cohort , 1993 .

[45]  Jodi L. Liu,et al.  National Health Spending Estimates Under Medicare for All , 2019 .

[46]  Master Textbook,et al.  Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health , 2017 .

[47]  Preliminary Analysis of Legislation That Would Replace Subsidies for Health Care With Block Grants , 2017 .

[48]  Shah Ebrahim,et al.  JOINT ESC GUIDELINES 2016 European Guidelines on cardiovascular disease prevention in clinical practice – Web Addenda , 2016 .

[49]  J. Roberson,et al.  A Long Road Ahead: Achieving True Parity in Mental Health and Substance Use Care , 2015 .

[50]  G Henderson,et al.  Physician burnout. , 1984, Hospital physician.