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A Little Problem of Equity

A Little Problem of Equity. Population. Health Care Spending. Source : Organization for Economic Cooperation and Development, 2006. The Great (And Expensive) Mismatch. Health System Spending $2.5 Trillion / Year. Influence. 10% 20% 20% 50%. “Social” Determinants.

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A Little Problem of Equity

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  1. A Little Problem of Equity Population Health Care Spending Source: Organization for Economic Cooperation and Development, 2006

  2. The Great (And Expensive) Mismatch Health System Spending $2.5 Trillion / Year Influence 10% 20% 20% 50% “Social” Determinants Sources: Centers for Disease Control and Prevention, University of California at San Francisco, Institute for the Future. Reprinted from Advances: The Robert Wood Johnson Foundation Quarterly Newsletter, 2000, Issue 1, supplement, page 1

  3. Provisions of Major Health Reform Proposals Senate HELP, Senate Finance, House Tri-Committee Common Provisions: • Individual mandate • Medicaid expansion • Premium subsidies – up to 400% FPL • Insurance regulations – renewability, guarantee issue, rating • New insurance gateway(s)

  4. Provisions of Major Health Reform Proposals (2) UnCommon Provisions: • Public insurance option – SFC = “Co-ops” • SCHIP expansion – SFC = to 250% • Employer mandate – not SFC • Primary care – SFC and House Tri = payments • Community prevention • CHCs – Senate HELP = funding to increase # CHCs and school-based clinics

  5. Where the Money Goes (Really),U.S., 2004 Source: Rough calculations based on CMS 2007 reports and estimates of administrative expenditures by UW Health Policy Analysis Program, 1990

  6. The Public Now Underwrites Most U.S. Health Spending Source: US Department of Health and Human Services, 2006; Katz estimate

  7. But the U.S. Does Have More Medical Technology MRIs / Million Population Source: Organization for Economic Cooperation and Development, 1999

  8. Health Insurance Premiums Outpace Inflation and and Workers’ Earnings

  9. The Big Squeeze: Health care spending displaces education funding 1986 2006 Source: Washington State Office of Financial Management, 2008

  10. A Confluence of Ideologies Conservative Values • Taking care of oneself and others • Preventing irresponsible free-riding • Reducing inefficiencies that burden business and entrepreneurialism Liberal Policies • Health coverage security • Mandated universal coverage • Publicly accountable budget, and uniform financing, payment, and benefits

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