Americans experienced a significant surge in death and illness in 2020 due to the COVID-19 pandemic. A new report published in PNAS, a peer reviewed journal of the National Academy of Sciences (NAS), suggests that mortality rates could have been significantly reduced if a universal healthcare system like Medicare For All had been implemented in the United States.

According to the report, which pulls data from a variety of sources, up to 212,000 American deaths could have been prevented due by universal healthcare during 2020. That number is significantly higher than the 76,064 preventable deaths calculated for 2019, the analysis says.

The research looked at a variety of factors, including increased access to primary care physicians, which the authors say would have led to a reduction in comorbidity-related COVID-19 deaths due to better management of underlying conditions. Moreover, Medicare For All could have reduced deaths by increasing access to doctors in general. With many people deterred from seeking medical care due to concerns about cost during the pandemic, those with COVID symptoms often delayed or avoided care, increasing their own risk of a negative outcome as well as the chance of spreading COVID-19 to others.