Yale Study Projects $1 Trillion Savings and 114,000 Lives Saved Under Universal Healthcare
Researchers at the Yale School of Public Health estimate that a national public insurance program could cut annual health expenditures by $1.04 trillion while averting over 114,000 deaths annually, even after accounting for expanded coverage costs.
A preprint study led by researchers at the Yale School of Public Health projects that implementing a single-payer universal health care system in the United States could reduce annual health expenditures by $1.04 trillion and save 114,174 lives annually. Based on 2024 data, the model estimates that savings from lower pharmaceutical prices, reduced administrative overhead, and fewer avoidable emergency visits would outweigh the $304 billion required to meet unmet medical needs and provide universal dental coverage.
The analysis, which has not yet undergone peer review, models a national public insurance program similar to the Medicare for All Act. Senior author Alison Galvani, the Burnett and Stender Families Professor of Epidemiology at YSPH, noted that healthcare costs have risen faster than inflation, driven by administrative middlemen, soaring drug prices, and emergency care for conditions that could have been treated earlier. The study argues that a universal system would strip out these sources of waste while ensuring coverage for every American.
The model identifies five primary drivers of the projected 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 regarding drug prices and fraud reduction, the researchers projected that annual savings would still reach at least $663 billion.
In terms of mortality, the study estimates that adequate coverage could avert 62,863 deaths annually, with nearly half of these occurring among the currently insured but underinsured population. This group comprises over 45 million working-age adults whose deductibles and cost-sharing effectively put care beyond financial reach. Additionally, reversing coverage rollbacks and health policies enacted since 2025 is projected to avert a further 51,311 deaths each year.
The findings build on a 2020 study published in The Lancet by the same lead author, which projected savings of $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 data on policy changes. The authors caution that the spending analysis does not account for transition costs, administrative job losses, or provider responses to payment rates, but conclude that the United States already spends enough to provide universal coverage.
