How did you arrive at these conclusions, which should be front and center in an election year around the country?

So in terms of the economics, we began with the country's status quo healthcare spending and built the proposed reform, Medicare for All reform, into that budget piece by piece.

So essentially, we analyzed the American healthcare system as a national balance sheet, and on one side of the ledger, we have covering The uninsured and expanding care for uninsured, you know, costs money, and we took into account that utilization will increase for people that currently have inadequate healthcare, ostensibly healthcare, but inadequate, like high deductibles or co-pays.

And when we initially started looking at this in 2019, and the paper was published in 2020, I anticipated a hefty price tag as well.

Our work has focused on, like, the effectiveness and cost efficiency of public health policies in the US and around the world, and usually we're asking how much will it cost to save lives, and we rarely get a no-brainer where you save money and you're saving lives.

So in terms of the savings, better access to primary care keeps conditions from escalating into avoidable emergency visit and hospitalization, so that's a significant component of the savings.

National drug price negotiations harnesses the purchasing power of the whole country and brings prices in line with what comparable wealthy nations already pay.

You started the study and started running the numbers, and this is what happened, correct?

Tell us about the changes in MMR vaccination rates in recent years.

Well, unfortunately, MMR coverage has been declining since twenty nineteen, with dramatic declines most recently.

And while coverage nationwide is still relatively high, vaccination uptake on a spatial scale has eroded enough to create dangerous immunity gaps.

That's just the number of people, in this case it's children, who are actually getting the vaccine.

And given this transmissibility, measles is unforgiving of complacency.

Because it's so highly transmissible, pockets of low vaccination can be enough to reverse the protection in terms of herd immunity that we've relied on for years.

Herd immunity is a population-wide coverage that is sufficient to reduce the transmissibility of a disease below the level where one person on average is infecting one other person.

How did you model the economic impacts of measles outbreaks?

And then I want to talk about, at the same time, these massive cuts to grants from the NIH, um, from the National Institutes of Health, that are shutting down everything from cancer research to in- um, investigating Alzheimer's, um, and other issues.

Well, one of the worst cuts to Medicaid is gonna be the requirement...

This, it's called the work requirement.

Um, but the problem is, and we've seen this implemented at state levels with terrible failure, to, to implement an aspect like that, uh, on the ground, it requires th-the government to have many more-... employees, so that's the taxpayers paying for that, it's actually (laughs) an inefficiency.

Um, going through the paperwork, people who are working a lot, you know, most people on Medicaid actually are working, but they will need to then prove that they're working, filling out forms, et cetera, um, and it's been found like there was an example in New Hampshire where they tried to implement something like this, um, there was a- an enormous exodus, um, out of their healthcare because, um, and then when they looked at who was leaving, they, those people were eligible for- Mm.

You address this in your letter to Senator Sanders, who is a lead proponent of universal healthcare, even the Democrats are not raising it, and yet this clearly would be a massive solution and cost-saving, life-saving solution.

Yeah, absolutely.

Uh, as you just said, to put this into context, we previously demonstrated that expanding healthcare to all Americans would save more than 68,000 lives, save more than 68,000 lives.