Improving the prognosis of health care in the USA.
Improving the prognosis of health care in the USA.
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DOI：
10.1016/s0140-6736(19)33019-3
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发表时间：
2020-02-15
期刊：
影响因子：
--
通讯作者：
Fitzpatrick MC
中科院分区：
文献类型：
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作者：
Galvani AP;Parpia AS;Foster EM;Singer BH;Fitzpatrick MC
尽管美国的人均医疗支出高于其他任何国家，但仍有3700多万美国人完全没有医疗保险，4100多万人无法获得足够的医疗服务。尽管正在进行的废除《平价医疗法案》的努力将加剧医疗保健的不公平，但一个普遍的系统，如《全民医疗保险法案》（MAA）中提出的系统，有可能改变美国医疗保健的可用性和效率。考虑到扩大覆盖范围的成本以及通过MAA实现的节省，我们计算出单一支付者的全民医疗保健系统可能会导致国家医疗保健支出节省13%，相当于每年超过4500亿美元。整个系统可以用比雇主和家庭目前通过医疗保险费以及现有政府拨款所产生的更少的财政支出来资助。这种向单一支付者医疗保健的转变将为低收入家庭提供最大的救济。此外，我们估计，确保所有美国人都能获得医疗保健，每年将挽救68，000多人的生命和173万生命年。
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.