I read with interest the recent article in the ARCHIVES by Karen Davis, PhD, and colleagues titled "A 2020 Vision for American Health Care"1 and the editorial by James Dalen, MD, titled "A Bold Proposal to Achieve Near-Universal Health Care Coverage in the United States."2 Universal coverage has several rarely appreciated cost-saving features. It is essential to recognize that universal coverage eliminates the costs of "niche" plans (eg, medical costs for automobile coverage, workman's compensation coverage, intensive care unit coverage, dual coverage with coordination of benefits, and disease-specific coverage such as cancer coverage). Universal coverage also eliminates the costs of underwriting.
Nevin WS. Cost-Saving Features of Universal Coverage. Arch Intern Med. 2001;161(15):1915-1916. doi: