Embed Size (px)
DESCRIPTION
Health Care Reform Universal Health Care: The Only Solution. 29 E Madison Suite 602, Chicago, IL 60602 Phone (312) 782-6006 | Fax: (312) 782-6007. PERSPECTIVE: Practical. Current system is unsustainable Burden it places on our economy/businesses - PowerPoint PPT Presentation
Citation preview
29 E Madison Suite 602, Chicago, IL 60602Phone (312) 782-6006 | Fax: (312) 782-6007
Health Care Reform Universal Health Care: The Only Solution
PERSPECTIVE: Practical
Current system is unsustainableBurden it places on our economy/businessesPrivate health insurance premiums are at
unsustainable rate of 13%/year – & as much as 25% in some areas of country
Coverage is shrinking, as more employers decide to cap their contributions to health insurance & workers find they cannot pay their rapidly growing share
Most expensive health care system in the world
PERSPECTIVE: PracticalSpend twice as much as other developed nations
We don’t get more care - Canadians, see their doctors more often & spend more time in hospital
We don’t get better results - do worse than most other developed countries on usual measures of health such as life expectancy, infant mortality, immunization rates
We still don’t cover everyone – 48.5 million uninsured
In sum, our health care system is outrageously expensive, yet inadequate.
Why?
There’s something enormously inefficient about the way we finance & deliver health care
Institute of Medicine Report
September 6, 2012Us Health System Wastes $750 billion Annually:
Unnecessary services- $210 billion
Inefficient delivery of care- $130 billionExcessive administrative costs- $190 billion
Inflated Prices- $105 billionPrevention failures- $55 billion
Fraud- $75 billion
PERSPECTIVE: PhilosophicalHealth care is :A Human RightA social service distributed according to
needNot a commodity distributed according to
ability to payNot a business whose “beneficiaries” are
company executives and investors not patients
Most Americans believe everyone should have access to good care without financial hardship
PERSPECTIVE: PhilosophicalWe are the only developed nation that does
not provide comprehensive health care to all its citizens
48.5 million Americans are uninsured
Many are underinsured - lack comprehensive coverage, preventive care, long-term care & drug costs
48,000 die a year from lack of coverage
Markets are good for many things, but they are not a good way to distribute health care
Problem with For-Profit Payers
Investor-owned firms compete not by quality or costs, but by avoiding unprofitable patients & limiting services
Creates paradox of a health care system based on avoiding the sick
It generates huge administrative costs, which, along with profits, divert resources from clinical care to demands of business.
Doctors & hospitals maintain costly admin staff to deal with bureaucracy
Administration consumes 31% of our health care $
Who Are the Uninsured?
Uninsured by Percentage
25%
5%
20%
50%
Children Unemployed
Out of Labor Force Employed
“…,people have access to health care in America. After all, you just go to an
emergency room.”Former President George W. Bush
America’s UnderinsuredProportion of Americans Going Without Care due to Costs, 2005
(skipping doctor visit, specialist appointment, treatment or prescription when needed)
Source: Commonwealth Fund Biennial Health Insurance Survey, 2005
28
60 59
0
10
20
30
40
50
60
70
1
Insured
Insured, Gap inCoverage
Uninsured
Medical Bankruptcy Illness & Medical Bills Contributed to 1,000,000 Personal
Bankruptcies in 2004. (Half of All Bankruptcies)
Source: Himmelstein, Health Affairs 2005 (state estimates provided by author)
Had Insurance
Insurance Status at Onset of Illness
24%
76%
Uninsured
Had Insurance
Health Care Americans Want
Guaranteed access
Free choice of doctor
High quality
Affordability
Trust & respect
Other Industrialized Nations
Have similar demographics
Availability of expensive technology
Rising drug costs
Similar levels of service
Why are their costs so much lower?
Why are costs lower in other countries?
Administrative simplicity
Lower prices
Higher ratio of primary care to specialists
Health planning
Global budgets
Life Expectancy, 2005Life Expectancy, 2005
Life Expectancy in Years
77.8
79 79
80.3 80.2 80.4 80.6
7676.5
7777.5
7878.5
7979.5
8080.5
81
U.S.
U.K.
Germ
any
Franc
e
Canada
Italy
Sweden
Series1
Infant Mortality, 2005Infant Mortality, 2005Deaths in first year of life
6.8
5.3 5 4.73.9 3.6
2.4
012345678
pe
r 1
0,0
00
liv
e b
irth
s
Maternal Mortality 2002/2003
8.9
2.9 3.2 3.6 4.2 4.6
0
2
4
6
8
10
De
ath
s/1
00
,00
0 B
irth
s
Source : OECD 2005
Growth of Physicians & AdministratorsGrowth of Physicians & Administrators 1970-20051970-2005
Source: Bureau of Labor Statistics & NCHS
One-Third of Health Spending is Consumed by Administration
Health Spending by Percentage
31%
69%
Administration All Other
Source: Woolhandler, et al, New England Journal of Medicine, August 2003 & Int. Jrnl. Of Hlth. Services, 2004
Health Costs’ Growing Share of Employee Benefits
Employer Spending on Benefits as a Percentage of Total Benefit Spending 1960-2002
0%
20%
40%
60%
80%
100%
1960 1970 1980 1990 2002
Other
Retirement
Health
Source: Employee Benefit Research Institute, May 2004
Lesson #1: Simply Giving More People Existing Private Insurance
Policies Is Not Solution:
Current Private Insurance Policies Offer Inadequate Protection.
Any Gains in Coverage Will Be Quickly Offset as Costs Rise & Employers Shed Benefits.
Lesson #2: Real Solution to Health Crisis Must Do 2 Things:
• Offer coverage more comprehensive than that currently available on the private market.
• Control Costs so that Benefits are Sustainable.
Only Two Paths to Reform1. Preserve Private
Insurance Companies & their Waste
2. Create a National Health Insurance System
Single-Payer BenefitsComprehensive Coverage for all medically
necessary services (doctor, hospital, long-term care, mental health, vision, dental, drug, etc.) in a single-tier system.
Free Choice of doctor & hospital.
Health Workers Unleashed from corporate dictates over patient care, and receive equitable payment for all care provided.
Hospitals guaranteed a secure, regular budget.
MedicareMedicare
MedicaidMedicaid
Payroll TaxPayroll Tax
Income TaxIncome Tax
Single-Payer Single-Payer Health Care Health Care
FundFund
$$$$$$
Financing Single-Payer
Bonus: Negotiated reimbursement for physicians, global budget for hospitals, primary & preventive care, bulk purchasing of drugs & medical supplies = long term cost control.
Funding a National Single-Payer
System“Medicare for All” would
save billions
Based on the work of Gerald Friedman
Professor of Economics at the University of Massachusetts-Amherst
Dollars & Sense March/April 2012
An Unrelenting Climb of Cost20%
16%
12%
8%
4%1960 1970 1980 1990 2000 2010
Healthcare spending as percent of GDP
Friedman, G. Dollars & Sense. March/April 2012
20/20 Vision for 202020%
16%
12%
8%
4%2013 2014 2015 2016 2017 2018 2019 2020
Projected share of GDP on healthcare
Friedman, G. Dollars & Sense. March/April 2012
Current system
Single Payer
The difference isinsurance company overhead and profits
Single Payer Would Cover Everyone And Spend Less
Friedman, G. Dollars & Sense. March/April 2012
$ Billions
Medicaid Rate Adjustment
Covering the uninsured
Increased utilization (especially home health and dental)
Government administration ($23B)Health insurance administration
Reduced market power (pharma and devices)
Admin costs to providers
New CostsSavings
$74$110
$142
$153
$178
$215
$200
0
-$200
-$400
-$600
Single Payer Would Cover Everyone And Spend Less
Friedman, G. Dollars & Sense. March/April 2012
New Costs:$326 B Net savings:
$243 BillionCover everyone
with better benefits and spend
less.
New Saving
s:$569 B
$ Billions
New CostsSavings
$200
0
-$200
-$400
-$600
Funding for Single Payer in 2013
Friedman, G. Dollars & Sense. March/April 2012
Dollars in Billions
Changes in Disposable Income
15%
10%
5%
0
-5%
-10%
-15%
-20%
Lowest 20%
Second
20%
Middle
20%
Fourth
20%
Next 15%
Next 4%
Top 1%
Changes in disposable income with single payer by income group
Friedman, G. Dollars & Sense. March/April 2012
With single payer,
95% of Americans would have more money in their
pocket.
Subsidy & Individual Mandate SchemesSubstandard Coverage: forces uninsured to buy defective
insurance industry products that are already causing families to face bankruptcy & go without needed care.
Unaffordable: Without savings achievable with single-payer, taxes must raised or funds diverted from other needy programs- education, infrastructure, transportation, etc.
Micro-coverage, Macro-costs: Preserves wasteful private insurers & adds yet another layer of state administrative waste. Rather than provide care to uninsured through a relatively efficient program like Medicare, the plan launders tax dollars through wasteful private insurers.
No Realistic Cost Control: Any gains in public coverage will be unsustainable due to rising costs.
“Sounds Great, but it’s not politically feasible”
2/3rds of population want it.
Most (59 percent) of physicians want it.
Business community is now realizing the need for it.
Single-Payer:Glen BartonFormer CEO, Caterpillar Inc. (Fortune 100)
Past Chairman, Health & Retirement Task Force Business RoundtableRepresents 150 Largest EmployersTotal Assets: $4.0 Trillion
“The quickest & simplest solution… is to go to a single-payer system”
- Written Testimony to AHCTF, Feb. 1 2006
“If done right, health care in America could be dramatically better with true single-payer coverage.”
--Ben Brewer, WSJ, April 18, 2006Ben Brewer, WSJ, April 18, 2006
“[single-payer] is an idea that's so easy to slam politically yet so sensible for business that only Republicans can sell it! …it may take a Republican President to bless the socialization of health spending we need.”
-Matt Miller, Fortune, April 18, 2006
““Think, as a small business, how you could benefit from a single-payer system: you wouldn’t lose potential employees to larger firms that offer more attractive health benefits; health insurance costs would cease to be a line item in your budget. A serious illness befalling you or an employee wouldn’t be a company-wide financial crisis. You might even save money.”
-Joseph Antony, CNBC / MSN Money, Winter 2003
CNBC / MSN MoneyCNBC / MSN Money
The Rising Popularity of National Health Insurance, 1979-2009
2009
Government
PrivateEnterprise
Don't Know
1979
Government
PrivateEnterprise
Don't Know
Who should provide coverage?
CBS News/New York Times Poll February 1st, 2009
Is “The Perfect the Enemy of the Good?”
The central flaws of the PPACA law remain the central flaws of our current system Uncontrolled CostsLack of Universal Coverage
Without eliminating the overhead of a patchwork for-profit system we will not achieve the system we deserve- health system reform must be pursued at the same time as quality reform.
Is “The Perfect the Enemy of the Good?”The Radical & the Republican
“Many of Lincoln’s admirers have painted him as a man who wanted exactly what the abolitionists did but cannily waited for a perfect moment to achieve it. [In fact], radicals like Douglass set an agenda Lincoln gradually adopted as his own. Without abolitionists, there would have been no Lincoln.”
- James Oakes, Historian, UC Berkeley
Single-Payer: “Politically Feasible?”Other “Politically Infeasible”
Movements
Abolition of Human Slavery (1860s)
Women’s Suffrage Movement (1840-1920)
Civil Rights Act (1964)
Voting Rights Act (1965)
