Galvani et all: Improving the Prognosis of Healthcare. Lancet 2020

“Although health care expenditure per capita is higher in the USA than in any other country, more than 37 million Americans do not have health insurance, and 41 million more have inadequate access to care. Efforts are ongoing to repeal the Affordable Care Act which would exacerbate health-care inequities. By contrast, a universal system, such as that proposed in the Medicare for All Act, has the potential to transform the availability and efficiency of American health-care services. Taking into account both the costs of coverage expansion and the savings that would be achieved through the Medicare for All Act, we calculate that a single-payer, universal health-care system is likely to lead to a 13% savings in national health-care expenditure, equivalent to more than US$450 billion annually (based on the value of the US$ in 2017). The entire system could be funded with less financial outlay than is incurred by employers and households paying for health-care premiums combined with existing government allocations. This shift to singlepayer health care would provide the greatest relief to lower-income households. Furthermore, we estimate that ensuring health-care access for all Americans would save more than 68 000 lives and 1·73 million life-years every year compared with the status quo.”

Source: Alison P Galvani, Alyssa S Parpia, Eric M Foster, Burton H Singer, Meagan C Fitzpatrick, Improving the prognosis of health care in the USA, The Lancet, Volume 395, Issue 10223, 2020, Pages 524-533, ISSN 0140-6736, https://doi.org/10.1016/S0140-6736(19)33019-3.
http://www.sciencedirect.com/science/article/pii/S0140673619330193
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)33019-3/fulltext

“Through the mechanisms detailed previously, we predict that a single-payer health-care system would require $3.034 trillion annually (figure 3; appendix p 5), $458 billion less than national health-care expenditure in 2017.⁴⁰ Even after accounting for the increased costs of coverage expansion, our data-driven base case includes $59 billion savings on hospital care, $23 billion on physician and clinical services, $217 billion on overheads, and $177 billion on prescription drugs (figure 3; appendix p 11). Consequently, annual expenditure per capita would decrease from $10,739⁶ to $9330, equivalent to a 13.1% reduction. The expectation of savings is robust and remains following variation in the input parameters. For example, if overhead costs only dropped to 6% of total health expenditure—rather than Medicare’s current 2.2%—the Medicare for All Act would still reduce costs by 10.3%. Conversely, savings would increase beyond our base case if our model overestimates the unfulfilled demand in people who do not have insurance or are underinsured. Given that $2,261 billion is already allocated to health care by existing governmental and philanthropic sources (appendix p 5), a further $773 billion must be collected by the government to fully fund the Medicare for All Act.”

Selected Resources On Single Payer / “Medicare For All”
A. P. Galvani PhD, et al., The Lancet, 2020: Improving the prognosis of health care in the USA

Cai et al, PLOS Medicine, 2020: Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses

Congressional Budget Office, 2019: Key Design Components and Considerations for Establishing a Single-Payer Health Care System

Political Economy Research Institute, 2018: Economic Analysis of Medicare for All

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Page last updated Jan. 14, 2021 by Doug McVay, Editor.