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Health Care. 4/17/2012. Learning Objectives. Accurately describe the social, economic, and political dimension of major problems and dilemmas facing contemporary American society

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Health care

Health Care

4/17/2012


Learning objectives

Learning Objectives

  • Accurately describe the social, economic, and political dimension of major problems and dilemmas facing contemporary American society

  • Use knowledge and analyses of social problems to evaluate public policy, and to suggest policy alternatives, with special reference to questions of social justice, the common good, and public and individual responsibility.


Opportunities to discuss course content

Opportunities to discuss course content

  • Today-11-2

  • Wednesday 10-2


Readings

Readings

Required

  • Health and Welfare (Chapter 5 pp 97-115) Dye

  • American Dilemmas Handbook pp. 27-38

    Optional

  • Health Care: Problems of Physical and Mental Illness (Chapter 10) Kendall


Health care1

Health Care


The problems of the system

The Problems of the System

  • Access

  • Cost

  • Quality


Problem 3 cost

Problem 3: Cost

  • Outpacing Inflation

  • Why


Cost labor

Cost- Labor

  • 5.5 People per patient (the old days)

  • Jobs that require skill and education

  • Recession Proof


Cost malpractice

Cost- Malpractice

  • Actually not the suits themselves

  • Defensive medicine

  • High Insurance- just in case


Cost greedy people

Cost- Greedy people

  • We want to get our benefits back

  • We do not realize the actual costs

  • A “Tragedy of the Commons”


Cost an older population

Cost- An Older Population

  • Our last years of life consume much of our health care dollar

  • We are living longer and there are more of us

  • More Care means more $


Cost and prescription drugs

Cost and Prescription Drugs

  • Average cost is $2400

  • 9 in 10 Seniors use a drug

  • Direct to Consumer Ads


Patient protection and affordable care act

The Solution

Patient Protection and Affordable Care Act


What is it

What is it

  • A law that will get health insurance to roughly 30 million Americans

  • Not a single payer system


What it looks like

What it looks like


How will it work expanding federal programs

How will it Work: Expanding Federal Programs

  • Getting those eligible on programs they are eligible for

    • Expanding Medicare Eligibility

    • Expanding COBRA health insurance

    • Expanding SCHIP Program


How will it work making changes to private insurance

How will it Work: Making Changes to Private Insurance

  • Cannot Deny for Pre-Existing Conditions

  • Cannot remove people who use up their coverage

  • The Slackers mandate

  • Subsidies to purchase insurance


How will it work individual mandates

How will it Work: Individual Mandates

  • People will be required to have health insurance

    • Just as we are required to have auto insurance

  • Up to 2.5% of income by 2016


What if i have insurance

What if I have Insurance?

  • In theory it should not change

  • Your employer, however, can just cut you off


When does it start

When does it start

  • Mandates begin in 2014

  • Costs should be lowered over time as people have insurance


How can we afford this

How can we afford this

  • 1 Trillion over first 10 years

    • Tax on Tans

    • Higher Medicare taxes on wealthy and Medicare cuts on providers

    • Taxes on High-end insurance

    • Fees on Health Care Industry


Upwards of 20 million mayremain uninsured

Upwards of 20 million mayRemain Uninsured

  • Illegal Immigrants and non-citizens (10 million)

  • People who do not sign up for eligible programs.

  • People who pay the penalty (mostly younger and single Americans.


Keeping the law

Keeping the law


Democratic strategy

Democratic Strategy

  • Draw a line on health care and do not let the Republicans cross it

  • Use institutional advantages to delay change

  • Focus on the popular parts of the law

  • Re-Cast the GOP into the Party of No (Part II)


Democratic advantage 1 laws are difficult to repeal

Democratic Advantage 1: Laws are Difficult to Repeal

  • They come in with political support and they retain that support

  • Minor changes and fixes only serve to strengthen the existing law!

  • Prohibition lasted for 13 years


Democratic advantage 2 marketing popular initiatives

Democratic Advantage 2: Marketing Popular Initiatives


Democratic advantage 3 divided government

Democratic Advantage 3: Divided Government

  • Use Senate Majority to control the Agenda

  • Filibuster when necessary

  • The Presidential Veto as a last resort


Democratic advantage 4 no new taxes in 2011 or 2012

Democratic Advantage 4: No new taxes in 2011 or 2012

  • FSA limits in 2013

  • Medicare tax increase by 0.9% and 3.8% tax on investments income for high-wage earners in 2013

  • Individual mandate in 2014

  • Cadillac Tax in 2018


Democratic advantage 5 debt and deficits

Democratic Advantage 5: Debt and Deficits


Repeal the bill through other means

The Republican Strategy

Repeal the bill through other means


Republican strategy

Republican Strategy

  • A straight-up repeal was unsuccessful

  • Continue to push the issue through other political avenues

  • Force this as a campaign issue in 2012


Republican advantage 1 consensus in the party

Republican Advantage 1: Consensus in the Party

  • The Republicans are unified in the support for repeal.

  • Try to exploit Democratic cleavages between those who want to keep the existing law, and those who may want to strengthen it.

  • Try to switch Democrats to their side


Gop advantage 2 public opinion

GOP Advantage 2 Public Opinion


Republican advantage 3 the individual mandate

Republican Advantage 3: The Individual Mandate

  • This is key to the success of the bill

  • And one of the least popular portions

  • Expect Heavy Resistance if the GOP tries

  • Which is exactly what the GOP wants


A court ruling in 2012

A Court Ruling in 2012


On repeal

On Repeal

Probably For Repeal

Probably Against Repeal

Ruth Bader-Ginsburg

Stephen Breyer

Sonia Sotomayor

Elena Kagan

  • Antonin Scalia

  • Clarence Thomas

  • Samuel Alito


On the fence

On the Fence

Chief Justice Roberts

Justice Anthony Kennedy


This makes the legal challenge a 2012 campaign issue

This Makes the Legal Challenge a 2012 Campaign Issue


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