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"Of all the forms of inequality, injustice in health care is the most shocking and most inhumane". Martin Luther King Jr (March 25, 1966, National Convention of the Medical Committee for Human Rights, Chicago). HEALTH CARE SECURITY FOR ALL. A moral, ethical, social & religious good

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"Of all the forms of inequality, injustice in health care is the most shocking and most inhumane"

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Of all the forms of inequality injustice in health care is the most shocking and most inhumane l.jpg

"Of all the forms of inequality, injustice in health care is the most shocking and most inhumane"

Martin Luther King Jr(March 25, 1966, National Convention of the Medical Committee for Human Rights, Chicago)


Health care security for all l.jpg

HEALTH CARE SECURITY FOR ALL

  • A moral, ethical, social & religious good

  • A family value

  • An economic necessity


46 million uninsured and rising l.jpg

46+ Million Uninsuredand Rising


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COSTS SOARING

TWO TRILLION DOLLARS

AND STILL RISING

15% OF GNP


18 314 adult deaths annually due to uninsurance l.jpg

18,314 Adult Deaths Annually Due to Uninsurance


Illness and medical costs a major cause of bankruptcy l.jpg

Illness and Medical Costs,A Major Cause of Bankruptcy

  • Over 50% of all bankruptcies involve a medical reason or large medical debt

  • 326,441 families identified illness/injury as the main reason for bankruptcy in 1999

  • An additional 269,757 had large medical debts at time of bankruptcy

  • 7 per 1000 single women, and 5 per 1000 men suffered medical-related bankruptcy in 1999

Source: Norton's Bankruptcy Advisor, May, 2000


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Who Pays for Nursing Home Care?

Source: Health Affairs 2000; 19(3):44


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  • Children

  • 25%

  • Unemployed

  • 5%

  • *Out of labor

  • force

  • Employed

  • 20%

  • 50%

Who Are The Uninsured?

*Students>18, Homemakers,

Disabled, Early retirees

Source: Himmelstein & Woolhandler - Tabulation from 1999 CPS


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The Eight Americas

  • 1. Asians,

  • 2. Northland low-income rural whites,

  • 3. Middle America,

  • 4. Low-income whites in Appalachia and the Mississippi Valley,

  • 5. Western Native Americans,

  • 6. Black Middle America,

  • 7. Low-income southern rural blacks

  • 8. High-risk urban blacks


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Disparities in mortality across the eight Americas are enormous by all international standards.

Policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US.

Health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries.


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Probability of death between the ages of 15 and 59 years in the eight Americas from all causes.


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Chronically Ill and Uninsured


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Netherlands

6%

France

8%

Sweden

9%

Canada

11%

UK

11%

Germany

11%

US

17%

0%

5%

10%

15%

20%

% of Population Below Poverty Level

Poverty Rates, 1997U.S. and Other Industrialized Nations

Source: Luxembourg Income Study Working PapersNote: U.S. figure for 1997, other nations most recent available year


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83

82.5

82

81.7

81.6

82

80.7

81

79.8

YEARS

80

79.4

79

78

77

U.S.

U.K.

ITALY

CANADA

FRANCE

SWEDEN

GERMANY

Life Expectancy For Women, 1999

Source: OECD, 2002 - Data on Italy are for 1998


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Why Women Delay Prenatal CareWhen They Know They Are Pregnant

Note: 11.1% of pregnant women failed to get timely prenatal care despite knowing they were

pregnant

Source: MMWR 5/12/2000; 49:393


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Health Care Administrative Costs in the U.S.

Administrative

Costs

31%

Clinical

Care

69%

$7 billion of the

WI healthcare dollar

is spent on administration

New England Journal of Medicine 8/03


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Health Care Financing Today

  • The financing of health care is really a shell game with all the payers trying to avoid paying the fixed costs of health care


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Cost shifting: No end in Sight

Deficit

Cost shift

Higher premiums

Bills not paid

Fixed costs

of

healthcare

services not met

More uninsured

More underinsured

Get Care


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CEO

Firm

Pay (mill)

Stock (mil)

Wilson Taylor

Cigna

$5.0

$64.2

Norman Payson

Oxford

$3.3

$44.7

Leonard Shaeffer

Wellpoint

$2.2

$45.5

Richard Huber

Aetna

$2.2

$21.3

William McGuire

United Hlthcr.

$1.5

$87.8

Melvin Goodes

Warner Lambert

$16.5

$287

Paul Ormond

Manor Care

$7.8

$43.7

Peter Nicholas

Boston Scientific

$0.8

$1198

Thomas Frist Jr.

Columbia/HCA

$.025

$445

CEO Pay and Stockholdings, 1998

Source: Jenks Healthcare Business Report 7/24/99


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Employers’ Health Benefit Costs US vs. Canada


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Drug Companies’ Cost Structure


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100%

100%

100%

100%

100%

100%

92%

80%

60%

45%

40%

20%

0%

U.S.

Germany

France

Canada

Australia

Japan

U.K.

Percent of Population withGovernment-Assured Insurance

Note: Germany does not require coverage for high-income persons, but virtually all buy coverageSource: OECD, 2002 - Data are for 2000 or most recent year available


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Who’s paying the Health Care bill?

Individuals

20%

60%

taxpayers

20%

{Medicare, Medicaid.

Public employees,

tax subsidies}

Private

employers

In the end, we all pay the total bill, but we

all don’t have coverage for our own care

Source: NEJM 1999; 340:109; Health Affairs 2000; 19(3):150


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We have the brains, resources and ability to resolve these problems so let’s do it.


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THREE PROPOSALS

  • WICONSIN HEALTH PLAN

  • WISCONSIN HEALTH CARE PARTNERSHIP PLAN

  • WISCONSIN HEALTH SECURITY ACT


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