Health

All actuarial estimates forecast savings with single payer the first year during the transition. This would be before preventative care starts to set in.
Another set of factors is fertilizer adds N, P & K but not minerals so our food has gotten less nutritious over the decades during the last 100 years. Then all the pollution in poor regions contributes to the variation in life expectancy. And finally the cumulative poison from nuclear waste, fossil fuel pollution and industrial pollution all of which end up in poor areas. The hollowing of the middle class since 1980 is another injury.