COVID-19 and Medicare for All.

COVID-19 is killing people. There can be no doubt that this will go down in history as one of the most devastating pandemics to hit our world. We will weather the storm, but we will be changed by it. Our lives will be different, our economy will be different, and our view of critical services like health care will be different. The question is, how? We are still in the midst of the battle but I have already heard people begin the argument that “socialized medicine” or “Medicare for all” would have made this better. I thought it might be interesting to do some comparisons between what is happening in the US at this point and what is happening in some of the nations that have socialized medicine. DISCLAIMER: I am not suggesting that this information is the only consideration and the data analysis here could change significantly. Still, from today’s perspective and using today’s data, here’s what we know. (NOTE: All statistics come from the John’s Hopkins University COVID-19 data and are as of 3/2/2020)


The US is one of the 10 nations hardest hit by this virus. The others on that list are Italy, Spain, France, China, Iran, the UK, Belgium, Netherlands, and Germany. While all of these nations have variations in their health care systems, most of them have systems that embrace some form of socialized medicine or government paid health care. I just wanted to track one core statistic in this review. What is the death rate among patients in each of these nations? The table below sets out the numbers.

A quick review shows a trend. Those nations with Single Payer health care system tend to have the highest mortality rates. Now, before you attack me here, I know that this little study does not take into account demographic differences or other possible factors, but the numbers are still pretty stark. France, Italy, Spain, UK and Netherlands all have single payer systems. All of those nations are currently showing the highest mortality rates with the lowest number coming in the UK at over 8.5%. Italy’s mortality rate of 12.07% is nothing less than shocking! At the same time, the lowest mortality rates on this list are in Germany and the United States. Both of those nations have multi-payer systems. Interesting me, is that in the middle we find Belgium and Iran with mortality rates in the 6.2%-6.5% range. Those two nations have healthcare systems that divide the load between partially public systems and private systems.

Even in New York, the hardest area of the United States, the total mortality rate to date is running at 2.66%. Despite fears of equipment and supplies shortages and the potential for the pandemic to overwhelm the hospital systems, New York has adapted and adjusted to the situation keeping the overall death rate lower than any of the European nations that appear on the top 10 list with the exception of Germany. And, New York has a higher total number of cases than any of those nations except Italy and Spain.


Can we make any conclusions? It may be too early in the overall process to make firm conclusions, but it seems to me that there are some possible truths emerging. What stands out most to me is that it appears systems like those in the US and Germany are better able to manage a health care crisis like Corona Virus. In my view what makes this true is the entrepreneurial nature of those systems. Private sector participants are engaged and motivated to produce speedy results that exceed the capability of government to respond. This is happening across the US and, it seems, also in Germany. Only time will tell if this holds true throughout the course of this pandemic. But for now, it is what I see.

CountryFirst CaseTotal CasesTotal DeathsMortality Rate
Italy1/30/2020115,24213,91512.07%
Spain1/31/2020112,06510,3489.23%
USA1/22/2020243,4535,9262.43%
France1/23/202059,9295,3989.01%
China12/30/202082,4323,3224.03%
Iran2/18/202050,4683,1606.26%
UK1/30/202034,1732,9268.56%
Netherlands2/26/202014,7881,3419.07%
Germany1/26/202084,7941,1071.30%
Belgium2/3/02015,3481,0116.59%