Health Care Facts and Health Care Facts and Guiding Principles for Guiding Principles for Health Care Reform Health Care Reform

Public Employees Union, Local Public Employees Union, Local #1 #1

Health Care Spending as a Health Care Spending as a Percentage of Gross Domestic Percentage of Gross Domestic

Product (GDP)Product (GDP)

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

1970 1990 1996 2003 2005

Source: Health Care Costs 101, 2005 – California HealthCare Foundation

How Does the U.S. How Does the U.S. Compare?Compare?

The U.S. spends a much greater portion of The U.S. spends a much greater portion of private dollars on health care than any private dollars on health care than any other countryother country In 2002, the U.S. government spent $2,364 In 2002, the U.S. government spent $2,364

per capita on health care (primarily Medicare per capita on health care (primarily Medicare and Medicaid) while the governments of and Medicaid) while the governments of Canada ($2,048) and France ($2,080) spent Canada ($2,048) and France ($2,080) spent lessless

Americans are paying more out-of-pocket Americans are paying more out-of-pocket than ever before for health insurance than ever before for health insurance

Deductibles and premiums are increasing, Deductibles and premiums are increasing, limiting the access to care.limiting the access to care.

In California the percentage of premiums paid In California the percentage of premiums paid by workers for a family plan has increased by workers for a family plan has increased from 23% in 2000 to 27% in 2004from 23% in 2000 to 27% in 2004

Priced Out: Health Care in California , John Garamendi 2005

Growth in Private Health Growth in Private Health Insurance Premiums 2000-Insurance Premiums 2000-

20042004

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

2000 2001 2002 2003 2004

National

California

Source: Health Care Costs 101, 2005 – California Health Care Foundation

Health Care Costs in the Health Care Costs in the News News

Did You Know…Did You Know…

1/21/2 of all bankruptcies in the United of all bankruptcies in the United States now relate to medical costs even States now relate to medical costs even

though though ¾¾ of the bankrupted families had of the bankrupted families had health coverage at the time of sustaining health coverage at the time of sustaining

the injury or illness. the injury or illness.

Going for Broke: Newsweek August 31, 2006

OUR GUIDING PRINCIPLES FOR OUR GUIDING PRINCIPLES FOR HEALTH CARE REFORMHEALTH CARE REFORM

Public Employees Union, Local #1 believes that Public Employees Union, Local #1 believes that healthcare for all is a human right not a luxury for those healthcare for all is a human right not a luxury for those who can afford to pay. In keeping with our Union’s values who can afford to pay. In keeping with our Union’s values we reject the assertion that the solution to escalating we reject the assertion that the solution to escalating costs is to continue the reduction of healthcare for our costs is to continue the reduction of healthcare for our communities. Instead, we must demand nothing less communities. Instead, we must demand nothing less than healthcare for all. than healthcare for all.

To accomplish healthcare for all over corporate interests, To accomplish healthcare for all over corporate interests, Local #1 will actively endorse reform of America’s Local #1 will actively endorse reform of America’s healthcare delivery and financing system, with an healthcare delivery and financing system, with an emphasis on supporting legislation before the California emphasis on supporting legislation before the California Legislature that will establish California as a model for Legislature that will establish California as a model for National Universal Health care. National Universal Health care.

Toward this goal we are guided by the following Toward this goal we are guided by the following principles: principles:

Guaranteed Coverage for Guaranteed Coverage for Everyone Everyone

Coverage shall not be denied for any Coverage shall not be denied for any reason.reason.

Coverage shall be portable and Coverage shall be portable and continuity of care assured whenever continuity of care assured whenever feasible.feasible.

Coverage shall be provided without Coverage shall be provided without regard to employment status. regard to employment status.

Coverage shall insure patient privacy Coverage shall insure patient privacy as per H.I.P.A.A. laws as per H.I.P.A.A. laws

Guaranteed Medically Guaranteed Medically Necessary Benefits Necessary Benefits

Universal benefits shall provide timely Universal benefits shall provide timely access to all medically necessary care. access to all medically necessary care.

Benefits shall emphasize and encourage Benefits shall emphasize and encourage preventative care, including immunization preventative care, including immunization of children and prenatal care. of children and prenatal care.

Chronic illness shall be managed to Chronic illness shall be managed to promote better health and control costs. promote better health and control costs.

Emphasis shall be placed on at-risk Emphasis shall be placed on at-risk populations and the elimination of populations and the elimination of economic and racial disparities in economic and racial disparities in healthcare and health status. healthcare and health status.

Fair Financing of Healthcare Fair Financing of Healthcare SystemSystem

Generate funding for universal healthcare by Generate funding for universal healthcare by consolidating different types of private insurances consolidating different types of private insurances and government healthcare programs. and government healthcare programs.

Reduce administrative costs through the universal Reduce administrative costs through the universal program and redirect the funds saved to treatment program and redirect the funds saved to treatment costs. costs.

Establish state and/or federal government as the Establish state and/or federal government as the authority to establish fair healthcare provider authority to establish fair healthcare provider reimbursement rates. reimbursement rates.

Creates universal financing based upon the ability Creates universal financing based upon the ability to contribute without creating an undue burden on to contribute without creating an undue burden on individuals or employers.individuals or employers.

Financial risks shall be spread as broadly as Financial risks shall be spread as broadly as possible while seeking to eliminate unnecessary possible while seeking to eliminate unnecessary costs and promote efficiency and fairness. costs and promote efficiency and fairness.

Meaningful Cost Controls Meaningful Cost Controls

Ensure cost effectiveness and Ensure cost effectiveness and accountability by standardization of pricing accountability by standardization of pricing of medical supplies, pharmaceuticals and of medical supplies, pharmaceuticals and hospital rates.hospital rates.

Ensure that provider and hospital practices Ensure that provider and hospital practices are oriented toward efficient delivery of are oriented toward efficient delivery of quality of care as medically necessary.quality of care as medically necessary.

Ensure that administrative costs are Ensure that administrative costs are directly related to the efficient and directly related to the efficient and effective delivery of the universal effective delivery of the universal healthcare system. healthcare system.

Freedom to Choose Freedom to Choose ProvidersProviders

Covered individuals shall be able to Covered individuals shall be able to choose their doctors and other healthcare choose their doctors and other healthcare providers, assuming they are available providers, assuming they are available and their practice allows. and their practice allows.

Publicize information to allow individuals to Publicize information to allow individuals to make informed decisions about provider make informed decisions about provider choices based upon hospital and choices based upon hospital and physician practices, utilization reviews and physician practices, utilization reviews and treatment outcomes. treatment outcomes.

Quality HealthcareQuality Healthcare

Improve the quality of care by reducing medical Improve the quality of care by reducing medical errors and avoiding unnecessary errors and avoiding unnecessary hospitalizations.hospitalizations.

Advance strategies that improve quality and Advance strategies that improve quality and efficiency across the healthcare system, such as efficiency across the healthcare system, such as evidence-based best practices and health evidence-based best practices and health information technologies and electronic record information technologies and electronic record systems.systems.

Create incentives for providers to improve Create incentives for providers to improve quality of care while delivering such care in a quality of care while delivering such care in a cost efficient manner. cost efficient manner.

Elder and End of Life CareElder and End of Life Care Provide integrated services that reduce costs and Provide integrated services that reduce costs and

maximize opportunities for individuals to receive in-home maximize opportunities for individuals to receive in-home assistance and community-based care, rather than in assistance and community-based care, rather than in hospitals and nursing homes. hospitals and nursing homes.

Be sensitive to and respectful of the patient’s and Be sensitive to and respectful of the patient’s and family’s wishes family’s wishes

Provide access to any treatment that will realistically be Provide access to any treatment that will realistically be expected to improve the patient’s quality of life. expected to improve the patient’s quality of life.

Provide access to palliative care and hospice care. Provide access to palliative care and hospice care. Respect the right to refuse treatment. Respect the right to refuse treatment. Respect the physician’s professional responsibility to Respect the physician’s professional responsibility to

discontinue some treatments when appropriate, with discontinue some treatments when appropriate, with consideration for both patient and family preferences.consideration for both patient and family preferences.