I suspect most if not all of my readership is on board with universal healthcare, but the Yale School of Public Health just released a new study, and I want to rant about it.
My fellow Americans, I don’t think you’re angry enough about healthcare in the US.
At this point, it’s more or less global common knowledge that the privatized healthcare system of the US costs a huge amount of money, in exchange for generally mediocre results. Those of us who follow this issue have known that tens of thousands of Americans die preventable deaths every year, because of the cost and inefficiency of healthcare. People are priced out of preventative medicine, and they avoid getting health problems checked out because they know they can’t afford treatment anyway, and so minor problems become major, and the price escalates accordingly.
I once heard an ER nurse say that “America doesn’t have a safety net, it has a greased chute. and at the bottom of that chute is one final trip to the emergency room”.
And it’s true. A majority of people manage to keep their heads above the water, but despite some small improvements under Obama’s ACA, it has gotten steadily worse. The US healthcare system was a big part of why my household decided to seek a better life in the lands of hope and opportunity across the Atlantic, and every time I worry it was a waste of the savings we spent to get here, I remember how much I have saved on health insurance, on healthcare, and how much better my health is because I know I can afford to get it checked out. That doesn’t mean things have been easy, but it’s hard to fully appreciate how much of a pyschological burden the US healthcare system is, until you’ve experienced something better. The UK’s NHS has its problems, as does the Irish system, but both of them are very clearly better, except perhaps for those with so much money they can easily fly to any specialist in the world.
A single-payer universal health care system could cover every American, save more than 100,000 lives a year, and still cost $1 trillion less than the system it would replace, according to a new preprint study led by researchers at the Yale School of Public Health.
First, to be clear, “preprint” means that this study has not yet gone through the peer review process. It certainly fits my preexisting opinions well, but I’m not competent to assess the research for myself, and those who are have yet to render their verdict. The authors also stress that they did not have data for excess deaths among uninsured adults, and their estimate does not include the logistical costs of transitioning to a universal system.
As I said, it’s been clear that the ACA was a band-aid on a bullet wound, and at best seems to have slowed the rate of decline. The Yale researchers ran a model based on 2024 statistics to see how a system like Medicare for All would play out, compared to the reality. As far as I know, this does not account for the eugenicist nightmare brought to us by RFK. Jr. and the Republican Party.
The model identified five major sources of savings: lower pharmaceutical prices, Medicare-level payments to providers, reduced administrative overhead, less fraudulent billing, and fewer avoidable emergency department visits and hospitalizations. Even under more conservative assumptions about drug prices and fraud reduction, the researchers projected that the savings would reach at least $663 billion a year. Both figures account for an estimated $304 billion in additional spending to meet unmet medical needs, reimburse care that now goes unpaid, and provide universal dental coverage.
A universal healthcare policy would also save tens of thousands of lives, the researchers project. They estimate that adequate coverage for all could avert about 62,863 deaths annually — and that nearly half, or 29,631, would be among people who already hold insurance. These are the underinsured: the more than 45 million working-age adults whose deductibles and cost-sharing put care beyond financial reach anyway. Reversing coverage rollbacks and other health policies enacted since 2025 would avert a further 51,311 deaths each year, the researchers project, bringing the annual total to 114,174.
The study builds on findings Galvani, co-author Meagan Fitzpatrick, and other colleagues published in The Lancet in 2020, which projected that universal health care would save $450 billion and more than 68,000 lives annually. The larger estimates in the new study reflect ballooning health expenditures, a widening gap between commercial and Medicare payment rates, and new estimates on recent policy changes and the underinsured.
The excess deaths and the excess money share the same root causes: Greed and a disregard for human life. Every death enriches the people deciding who gets to live and who doesn’t. Let no defender of this system ever call themselves “pro-life” again, lest their hearing be damaged by derisive laughter.
The US already spends more than enough to cover a universal system, but a huge portion of that currently goes to advertising, to buying politicians, and to buying extra yachts and doomsday bunker mansions for executives and shareholders. We can do better.
And so I’d like to close with this thought exercise for my fellow Americans: Think about how much your health insurance costs. If you get it through your employer, include how much they contribute. How would your life change if that money was going into your pocket instead? What would you do with that money? How would it change your life?
Now add to that an end to medical bills as you know it. No more surprise letters demanding hundreds of dollars for an ambulance ride, or thousands for the treatment once you reach the hospital. No more worrying that if you get that pain checked out it’ll lead to medical bankruptcy. No more worrying that end-of-life medical care will leave your family with nothing.
It wouldn’t solve all of your problems, and no healthcare system is perfect, but imagine if yours was centered around your health and well-being, rather than the greed of a bunch of rich ghouls who get richer every time they deny someone needed care.
The world could be so much better for everyone than it is.
I’m Britash and I’ve only ever lived in countries with universal healthcare. Currently, given my age, it costs me about $5 to see a doctor, a similar amount for monthly tests, and $8-$12 for a month’s medication (which includes blood pressure and heart; which at my age would otherwise kill me). Why is America so behind the curve?
They should also have included how much the economy would benefit from fewer bankruptcies. Over 65% of personal bankruptcies are due to medical debt. There’s also the lost labor costs of people getting seriously sick or disabled for lack of preventive care. Perhaps slightly counterbalanced by employment losses in the yacht industry…
I’ve also lived in both the UK and the US, and it’s wild how different the medical systems are. The US is so surreal in that, if you have money and/or good insurance and live in a large city, you can get access to absolutely world-class care at the cutting edge of medical science, but if you have poor or no insurance, you’re basically just left to rot unless you can weasel your way into receiving medicaid (which they make as difficult as possible). Dental care is nuts here too: they want paid the day services are rendered, and the costs are insane. Need an endodontic evaluation for a broken tooth or pain? I hope you have money, or sufficient credit to be able to take out a loan, or they will just let you suffer.
@1 tonykehoe:
Well organized advertising campaign that has convinced many Americans that health care in other countries is terrible. When in reality health care in the US is top of the line only if you have good insurance or are rich. Often with piles of misleading statistics. Health care systems are big and they all have their quirks, digging around enough they can usually find something that is worse then US care.
There is also a long running political advertising campaign that teaches Americans to consider socialism, communism and authoritarian governments as being equivalent. The points around economic systems and political systems being different are intentionally squashed. That communism vs capitalism is a spectrum and all successful governments are a mix of systems is treated as heresy.
two other things you don’t have in single payer systems – ‘out of network’ (there is only one network) and ‘pre approval’ (it isn’t up to the insurer. if your doctor says you need it then you get it)
you also have to factor in the Value of a Statistical Life (VSL). This is used by governments to estimate how much
society is willing to pay to reduce the risk of death. By convention, the life is assumed to be the life of a young adult with at least 40 years of life ahead. It is not placing an actual worth on a persons life, but takes into account overall contribution to society. Figures vary but an average is about $5m.
So saving 68,000 lives annually is an annual benefit to the community of $340B. Or, the community would have to spend more than $340B before the costs could not be justified. The fact you can get that $340B in benefit while actually spending *less* should make it a no-brainer
Growing up, I heard North Korea described as a country where the government convinced its people they were the most technologically advanced society in the world, with an excellent standard of living.
I still don’t know much about NK, but it has become clear that that is what the US has become. Most of the world was persuaded by US dominance and US propaganda to believe that life in the US was as good as it got, and Americans got that message more than anyone.
At a broader level, it seems a huge number of USians have been convinced that any effort to improve the USian standard of living through the government will inevitably lead to catastrophe – the world is too big or complicated, so it requires the machine of capitalism to generate the best possible results. Trying to meddle with that will lead to communism, which has killed hundreds of trillions of people since Satan wrote the Communist Manifesto in the Garden of Eden.
@JM – they’re ramping back up the “left=authoritarian” thing even as they’re equipping the American SS with torture gloves. It’s a useful conversation-stopper because it can be collapsed into a yes-or-no question that makes it hard to insert any perspective or nuance. It also carries the false implication that the US is somehow NOT authoritarian.
Oceanoxia wrote in the OP,
I don’t have to look this up, I was curious about this last year and have the numbers in front of me.
Yearly numbers for 2025 – Myself and Spouse on Corporate Health Care Plan – High Deductible ($10,000), no dependants.
Medical Care/Prescriptions: Me = $3,636.10, Company = $12,610.68
Dental Care: Me = $444.08, Company = $375.36
Vision Coverage: Me = $252.72, Company = $0
Company Life Insurance/Disability: Me = $0, Company = $670.59
So I’m paying $4,332/year (~$360/mo) and my company is paying $13,656/year (~$1138/mo). In addition, there is also $924/year ($77/mo) from myself and $924/year ($77/mo) from my company being paid into a Health Savings Account so that I have some savings to pay against the deductible. Add it all together and it’s close to $20,000/year for health care for my wife and myself, $5,000 paid by me, $15,000 paid by employer. Now, I’m not foolish enough to think that I would get all that money should we move to a single-payer system, but if corporations saw that they could reduce their health care budgets from say, $15,000/employee to $10,000/employee as a tax to pay for employee health care (and eliminate a number of HR employees in the process), you would think they would jump at it. However, it looks to me like employers are looking at pushing ALL health care costs onto their employees, every year the percentage I have to pay goes up.
High deductible means that I pay the first $10,000 for most medical care, although a lot of the routine doctor’s visits are partially covered. E.g. A $500 annual check-up bill may be reduced by ~$200 because of a negotiated plan between the insurer and the medical provider, then the insurance may pay $120 of it, while I get a bill for $180. Which I try to pay out of my HSA, which I can only (by law) contribute to because I have a high-deducible plan. I switched to a low deductible plan one year and I was told I could not contribute to my HSA because I had a low-deductible plan (I could still spend out of it).
The entire system is confusing, obviously deliberately. Any time I have an issue I spend hours on the phone calling at least 3 different organizations multiple times, each pointing the finger at someone else. Of course their automated systems (either phone or on-line) are not capable of looking into issues, and it take hours to get a real person on the phone to explain a problem.
@Oceanoxia #7:
I remember seeing a Letter to the Editor in the Toronto Star back in University (so late 1980s/early 1990s) from someone who said that he had spent half his life in the U.S. and half in Canada, so thought he had a decent perspective on the differences between the two. This was in response to an article built around an American political cartoon which basically went “But if we do something like the Canadian health care system, then where will Canadians go to get good health care?”
His comment on the health care system differences, even back then, was basically “Americans have been taught all their lives that their country is the greatest and most advanced ever, so any problem that they haven’t solved is probably insoluble, and they will gladly shoot the messenger who comes to point out that other people have already in fact solved it.”
And, of course, while a lot of Americans do have the original attitude about Canadians coming to America to get ‘good health care’, and a lot of such Canadians do exist, they’re the ones rich enough to queue-jump into a system that allows it.