“We believe the available research supports the conclusion that a program of Medicare for All (M4A) could be considerably less expensive than the current system, reducing waste and profiteering inherent in the current system, and could be financed in a way to ensure significant financial savings for the vast majority of American households.”

Twenty leading U.S. economists released an open letter on Tuesday arguing that a single-payer health care system would save tens of thousands of lives and hundreds of billions each year. The economists’ letter comes amid fallout from the coronavirus pandemic and questions about how the U.S.’s uniquely for-profit healthcare system will respond to the need for mass testing and treatments.

“We believe the available research supports the conclusion that a program of Medicare for All (M4A) could be considerably less expensive than the current system, reducing waste and profiteering inherent in the current system, and could be financed in a way to ensure significant financial savings for the vast majority of American households,” the economists wrote in the open letter.

American voters consistently cite healthcare as their most important issue. At around 18% of GDP, American per capita health care expenditures are more than twice the average of the 35 advanced countries in the Organization for Economic Cooperation and Development (OECD). Yet despite outspending these countries, the U.S. “has the lowest life expectancy, the greatest incidence of chronic illnesses, and the highest infant, child, and maternal mortality rates” in the OECD, according to economist Robert H. Frank.

“There’s been too much loose talk that Medicare for All is unaffordable,” Dr. Gerald Friedman told Business Insider. “What’s really unaffordable is the current system. We spend about twice the average for affluent countries in the OECD on healthcare.”

“Most important, Medicare for All will reduce morbidity and save tens of thousands of lives each year,” the group of economists said in the letter.

One Harvard study found that 45,000 Americans die per year because they are uninsured. According to the American Journal of Public Health, medical bills or missed work from illness drive 500,000 Americans into bankruptcy every year. Meanwhile, new research from the medical journal Lancet shows that Medicare for All would save more than 68,000 lives and $450 billion a year

“No developed country other than the United States relies on largely unregulated insurance companies for the provision of health care,” Economist Robert H. Frank told Evonomics last year, citing America’s weakly regulated profit-driven health care model as the reason for higher costs and worse outcomes.

In 20 states in a row, Democratic primary voters have voiced their support for Medicare for All over the current system in exit polls. But in an interview with MSNBC on Monday, leading Democratic nominee Joe Biden suggested that he would veto Medicare for All legislation should it pass Congress. Biden’s strong Super Tuesday performance over former front runner Bernie Sanders, who champions a Medicare for All system, caused health insurance stocks to surge at the prospect of a candidate more amenable to their industry’s interests.

Coronavirus And U.S. Health Care System

National Nurses United President Jean Ross told DemocracyNow on Wednesday that the current system has left health care workers unprepared to handle the scale of the Coronavirus crisis, and argued that a national health insurance plan would help the country care for lower income Americans, who are disincentivized from seeking treatment and therefore more likely to spread the virus to others.

“Well, if we had a national healthcare system, like some other countries do, we would be in a far better position. For example, if you look at a country like Canada, who had to undergo the SARS crisis, and they were able to do it in large part because of that system,” said Ross. “We have such a patchwork here that’s dependent on profit. Then our homeless communities, our immigrants, that you mentioned, those of lower economic status are going to be the ones hardest hit. They’re going to not want to come in, because they don’t have the money to pay.”

While President Trump claimed on Wednesday night that major U.S. insurance companies “have agreed to waive all copayments for coronavirus treatments” in order to curb the spread of the disease, a spokesperson for America’s Health Insurance Plans (AHIP), a top insurance industry lobbying group, clarified to a Politico reporter that waived copays were strictly “for testing. Not for treatment.”

Read the economists’ open letter in full below:

We are economists interested in public policy and healthcare. Some of us have worked to estimate the cost of alternative healthcare programs. Others have reviewed such estimates. We believe the available research supports the conclusion that a program of Medicare for All (M4A) could be considerably less expensive than the current system, reducing waste and profiteering inherent in the current system, and could be financed in a way to ensure significant financial savings for the vast majority of American households. Of course, the details would depend on the design of the M4A system.

Compared with the current system, Medicare for All would achieve considerable savings on administration and by reducing payments to monopoly drug companies and hospital networks. Within a few years of operation, M4A could save hundreds of billions of dollars per year from these sources. Additional savings will come when a rational healthcare finance system allows needed investments in coordinated care and preventive care, as well as reductions in fraudulent billing. Over time, global budgeting would slow the rate of future healthcare costs significantly, as has been done in Canada and other countries. Bending the cost curve could save more than $2 trillion over the next decade, and even more with a well-designed system. Costs will be predictable, enabling households and businesses to plan in a way that is impossible today.

There are added costs associated with Medicare for All. Universal coverage and increased utilization, coming from reduction or elimination of cost sharing, will add costs, but studies show that these added costs will be far less than the savings outlined above.

The need for increased public funds (replacing premiums) can be financed with some combination of payroll, income, and wealth taxes. By eliminating insurance premiums and out-of-pocket expenses, and lowering overall healthcare costs, Medicare for All will result in enormous savings for almost all households, all except the richest households who will pay more in taxes. Shifting the burden from per-person payments for premiums and cost sharing to income- and wealth-related taxation will magnify the savings for most households. The current system is particularly burdensome for middle-income working households who receive relatively little support through Medicaid or other public programs but are responsible for health insurance premiums either paid directly or by their employer as nonwage compensation. A system that cuts costs and shifts financing to income and wealth taxes will dramatically lower this burden, producing significant savings for workers and businesses.

The net financial savings will be accompanied by substantial improvements in productivity through improved health, and the elimination of “job lock” coming from the need to stay on a job to retain health coverage. Most important, Medicare for All will reduce morbidity and save tens of thousands of lives each year.

James G. Kahn, Professor, Institute for Health Policy Studies, School of Medicine, University of California, San Francisco

Jeffrey Sachs, University Professor and Director, Center for Sustainable Development, Columbia University

Anders Fremstad, Assistant Professor, Economics, Colorado State University

Robert Reich, Carmel P. Friesen Professor of Public Policy, Goldman School of Public Policy, University of California, Berkeley

Robert Pollin, Distinguished University Professor of Economics and Co-Director of Political Economy Research Institute, University of Massachusetts Amherst

Leonard Rodberg, Professor Emeritus of Urban Studies, Queens College/CUNY

Emmanuel Saez, Professor of Economics, Director, Center for Equitable Growth, University of California at Berkeley

Gabriel Zucman, Associate Professor of Economics, University of California at Berkeley

Alison Galvani, Burnett and Stender Families’ Professor of Epidemiology, Director of the Center for Infectious Disease Modeling and Analysis, Yale School of Public Health

Gerald Friedman, Professor of Economics, University of Massachusetts at Amherst

Katherine Moos, Assistant Professor of Economics, University of Massachusetts at Amherst

Lindy Hern, Associate Professor of Sociology, University of Hawaii at Hilo

Lawrence King, Professor of Economics, University of Massachusetts at Amherst

Michael Ash, Professor of Economics, University of Massachusetts at Amherst

Markus P. A. Schneider, Associate Professor of Economics, University of Denver

Jeff Helton, Associate Professor Health Care Management College of Professional Studies, Metropolitan State University of Denver

Mark Paul, Assistant Professor of Economics, New College of Florida

Elissa Braunstein, Professor & Chair, Department of Economics, Colorado State University

Dean Baker, Senior Economist, Center for Economic and Policy Research and Visiting Professor of Economics, University of Utah

Darrick Hamilton, Professor of Economics and Sociology and Executive Director of the Kirwan Institute for the Study of Race and Ethnicity at The Ohio State University