根据新的研究，全民医保每年将拯救68,000多人的生命，节省4500亿美元

根据新的研究，全民医保每年将拯救68,000多人的生命，节省4500亿美元

Epidemiologists from the Yale School of Public Health, University of Florida, and University of Maryland School of Medicine, have calculated that a single-payer universal health-care system in the US would likely lead to a 13 percent saving in national health-care expenditure and prevent more than 68,000 unnecessary deaths. By replacing premiums, deductibles, co-payments and out-of-pocket costs with a progressive tax system, Medicare for All will not only save the average family around $2,400 a year, but also give lower-income families access to the services they need, the researchers say.

耶鲁大学公共卫生学院、佛罗里达大学和马里兰大学医学院研究人员说，在美国，单一支付款的全民医疗保健系统可能会使全国医疗保健开支节省13%，并避免6.8万多不必要的死亡。通过用累进税制取代保险费、免赔额、共同支付和自付费用，全民医保不仅将为普通家庭每年节省大约2400美元，而且还将使低收入家庭获得他们需要的服务。

Katy Pallister

Published in The Lancet, the study first sets out the current state of affairs. Over 78 million Americans (24 percent of the US population), do not have adequate access to care. This number includes over 37 million Americans who have no health insurance at all. However, the situation could get worse. “The move to repeal the Affordable Care Act by the Trump administration will further jeopardize the health care of 21 million Americans,” the researchers warned in the paper, which would “exacerbate health-care inequities.”

发表在《柳叶刀》杂志上的这项研究首先阐述了当前的情况。超过7800万美国人(占美国人口的24%)没有足够的医疗服务。这个数字包括3700多万没有医疗保险的美国人。然而，情况可能会变得更糟。“特朗普政府废除《合理医疗费用法案》的举动，将进一步危及2100万美国人的医疗保障，”研究人员在论文中警告说，这将“加剧医疗不公平”。

A single-payer, universal health care system in the U.S. would save >68,000 lives and more than $450 billion annually, writes YSPH Prof. Alison Galvani and colleagues in the current issue of The Lancet.

YSPH教授Alison Galvani及其同事在最新一期的《柳叶刀》杂志上写道，美国的单一付款人全民医疗体系每年将拯救6.8万人的生命，节省4500多亿美元。

Already the USA ranks poorly for many public health indicators, such as preventable deaths, infant survival, and maternal mortality, given its national health expenditure is higher than any other country. Repealing the Affordable Care Act would result in an additional loss of more than 38,500 lives, the team writes in their paper. However, employing the Medicare for All Act would save over 68,500 lives, compared to the status quo.

美国在许多公共卫生指标上的排名已经很低，比如可预防的死亡、婴儿存活率和产妇死亡率，因为美国的国家卫生支出高于其他任何国家。该小组在他们的论文中写道，废除《合理医疗费用法案》将导致38500多人的额外死亡。然而，与现状相比，实施全民医疗保险法案将挽救68,500条生命。

This life-saving effect that the Medicare for All Act would achieve is calculated from just one group of people: those that are uninsured. In this group, people are reported to experience a 40 percent elevation in age-specific mortality risk. If all Americans became insured, the universal coverage would save tens of thousands of lives, and around 1.73 million life-years annually.

《全民医疗保险法案》所能达到的这种拯救生命的效果，仅仅是从一群人身上计算出来的:那些没有保险的人。在这一组中，据报道，人们在特定年龄的死亡风险方面提高了40%。如果所有美国人都上了保险，全民医保每年将挽救数万人的生命，并可延长约173万年的寿命。

Accompanying the paper is an interactive tool, called the Single-Payer Healthcare Interactive Financing Tool (SHIFT). Here, the economics of the Medicare for All Act can be analyzed using a number of parameters involving the health-care budget, expansion in service use, and revenue generation. Across a wide range of assumptions, projections from SHIFT indicate net savings for the health-care system. In the researchers' base case the savings would include $59 billion on hospital care, $23 billion on physician and clinical services, $217 billion on overheads and $177 billion on prescription drugs.

本文附带了一个交互式工具，称为单一支付者医疗保健交互式融资工具(SHIFT)。在这里，全民医疗保险法案的经济效益可以通过一系列参数进行分析，这些参数包括卫生保健预算、服务使用的扩大和收入的产生。通过一系列广泛的假设，SHIFT公司的预测表明，医疗系统将会有净节省。在研究人员的基本情况下，将节省590亿美元的医院护理，230亿美元的医生和临床服务，2170亿美元的日常开支和1770亿美元的处方药。

Previous objections to Medicare for All based on the expectation of rising costs are mistaken, write the authors. Although further opposition from health insurance and pharmaceutical industries should be expected, the authors believe that “the moral imperative to provide health care as a human right, not dependent on employment or affluence,” should counterbalance any concerns.

作者写道，先前基于成本上升预期而反对全民医疗保险是错误的。尽管医疗保险和制药行业可能会进一步反对，但作者认为，“提供医疗服务作为一项人权的道义责任，而不是依赖于就业或富裕”，应该能够抵消任何担忧。

Lead author of the study Professor Alison Galvani shared a clip of Democrat presidential nominee candidate Bernie Sanders discussing the paper in Carson City, Nevada at the weekend on Twitter.

该研究的主要作者Alison Galvani教授周末在推特上分享了民主党总统候选人伯尼·桑德斯在内华达州卡森市讨论该论文的一段视频。