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Conversation Coalition For Health Care Reform Can we have comprehensive health care reform that provides all medically necessary care to all residents and saves money? HEALTH CARE HISTORY IN 2 SLIDES:

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slide1

Conversation Coalition

For Health Care Reform

slide2

Can we have comprehensive health care reform that provides all medically necessary care to all residents and saves money?

health care history in 2 slides
HEALTH CARE HISTORY IN 2 SLIDES:
  • Europe: The destruction of WWII required the restoration of security through social institutions. Created a system based on human rights.
  • The US retained an employment-based system of health care.

1960s belief:

  • Private insurance industry would respond quickly to a changing medical economy and cover everybody within 10 years.
health care history in 2 slides4
HEALTH CARE HISTORY IN 2 SLIDES:
  • In the 1980s, a fundamental shift occurred to private investor-owned health corporations.
  • Health care was perceived as a fertile field for profit seeking businesses. In this new environment

Health became a commodity,

patients became consumers

the result
THE RESULT:
  • The United States is one of three industrialized nations that does not have a

HEALTH CARE SYSTEM

consequences of no system
CONSEQUENCES OF NO SYSTEM:
  • Expensive
  • Low quality/poor outcomes
  • Lack of prevention
  • People avoid medical care
  • Lack of coordination/medical errors
  • Increasing disparities
  • Losing primary care doctors
spending too much
SPENDING TOO MUCH
  • We spend two times more and cover less; fewer benefits and fewer people
getting too little
GETTING TOO LITTLE

AMONG INDUSTRIALIZED NATIONS THE U.S. HAS:

  • The lowest ranking in health care
  • The highest infant mortality
  • The highest maternal mortality
  • The lowest life expectancy
even insured do not receive adequate preventive care
EVEN INSURED DO NOT RECEIVE ADEQUATE PREVENTIVE CARE

Percent of adults (ages 18+) who received all recommended screening and

preventive care within a specific time frame given their age and sex*

* Recommended care includes seven key screening and preventive services: blood pressure,

cholesterol, Pap, mammogram, fecal occult blood test or sigmoidoscopy/colonoscopy, and flu shot.

Data: B. Mahato, Columbia University analysis of 2002 Medical Expenditure Panel Survey.

Source: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2006.

incentive to avoid health care
INCENTIVE TO AVOID HEALTH CARE:
  • 29(47%)% households - someone skips a medical treatment, cuts pills or does not fill a prescription because of cost
  • 23%(32%) Americans have problems paying medical bills
  • 21% Americans had an overdue medical bill.
  • 1 million people experience medical bankruptcy each year Health Care Costs Survey, USA Today/Kaiser Family Foundation/Harvard School of Public Health, August 2005; D. Himmelstein et al, Health Affairs, 2005( KFF Survey Oct., 2008)
preventable deaths
PREVENTABLE DEATHS

The number of preventable deaths (per 100,000) from treatable conditions in 19 leading industrialized nations (2002-2003):

  • 1. France = 64.8
  • 2. Japan = 71.2
  • 3. Australia = 71.3

The worst:

  • 19. United States = 109.7 = 110,000preventable deaths per year!

(due to lack of access to care)

Journal of Health Affairs

increasing health disparties
INCREASING HEALTH DISPARTIES
  • For most core quality measures, Blacks (73%), Hispanics (77%), and poor people (71%) received worse quality care than their reference groups.
  • For most measures for poor people (67%) disparities were increasing.
  • Increasing disparities were especially prevalent in chronic disease management.

Agency for Healthcare Research and Quality: National Healthcare Disparities Report, 2006.

losing primary care
LOSING PRIMARY CARE:

Shortages in pediatrics, internal medicine and family medicine.

Decreased access to geriatricians and gynecologists.

Low interest by medical students because of:

high student loan debt

malpractice insurance

low starting salaries

what would you choose
WHAT WOULD YOU CHOOSE?
  • The current average graduation debt is: $155,000
  • Medical school tuition is increasing
  • Loan deferment is disappearing
  • Primary care physicians earn 30% less (2006)
slide15

Administration is the Fastest Growing job in Health Care

Source: Bureau of Labor Statistics and NCHS

1 3 of health spending is spent on administration
1/3 OF HEALTH SPENDING IS SPENT ON ADMINISTRATION

Administrative

Costs

($2000 per person)

Clinical

Care

31%

69%

Source: Woolhandler, et al, New England Journal of Medicine, August 2003 & Int. Jrnl. Of Hlth. Services, 2004

if you were in an insurance company ceo who would you insure
IF YOU WERE IN AN INSURANCE COMPANY CEO, WHO WOULD YOU INSURE?

73%

80% uses less than $1000

of care per year

Percent

of

health

Care

Expenditures

13%

6%

4%

0% 0% 0%

1% 1% 2%

Source:Agency for Healthcare Research and Quality

MEPS, 1999

what s wrong with this picture
WHAT’S WRONG WITH THIS PICTURE?

Premiums are rising five times faster than inflation

what is universal health care
WHAT IS UNIVERSAL HEALTH CARE ?

Respect for human dignity demands that no one refrain from seeking medical care from fear of the consequences of doing so, and that no one suffer financial adversity as a result of having sought care. The moral foundations of universal coverage are as simple as that.

  • American Journal of Public Health January 2003, vol 93
achieving universal health care
ACHIEVING UNIVERSALHEALTH CARE
  • COMPREHENSIVE REFORM:

fundamental reform that reorganizes the funding, unifies the administrative process and creates a health care system that serves the whole community.

  • BANDAID REFORM:

patchwork reforms that expand current health care programs, shift responsibility to the individual and/or subsidize the purchase of health insurance.

the latest fix massachusetts
THE LATEST “FIX”: MASSACHUSETTS

Percent of previously uninsured newly covered as of 11/1/07, calculated from CPS

three ways to extend health care coverage
THREE WAYS TO EXTEND HEALTH CARE COVERAGE
  • Rights-Based:Access is given to all residents and is funded through progressive taxation. The only proven means of achieving universal coverage.
  • Incentive-Based: Access is purchased and voluntary, but subsidies/tax credits are offered as incentives.
  • Criminalization:Purchasing access is required by law, failure to purchase access is penalized.
creating health security
CREATING HEALTH SECURITY
  • Unified risk pool – everybody in, nobody out.
  • Everybody contributes to fund health care based on ability to pay.
  • All medically necessary care is covered.
  • Simplified administration saves money.
  • Focused on preventative and timely care.
  • Transparency and Accountability to the public
slide29

H.R. 676

THE UNITED STATES NATIONAL HEALTH INSURANCE ACT

(Expanded and Improved Medicare For All)

“We will never be able to control health care costs and provide quality health care to all Americans unless we establish a universal health care system with single payer financing.”

- Dr. Marcia Angell

goals of h r 676
GOALS OF H.R. 676

To ensure that all Americans have:

  • A single standard of high-quality, affordable health care guaranteed by federal law
  • Access to health care services whenever medical attention is needed
who is eligible
WHO IS ELIGIBLE?
  • Every person living in the United States is eligible from birth throughout life
  • Every person living in the United States and the U.S. Territories would receive a United States National Health Insurance Card & ID number once enrolled
accessing healthcare services under h r 676
ACCESSING HEALTHCARE SERVICES UNDER H.R. 676
  • All patients are presumed eligible to receive services, even if not carrying card at time of need
  • Patients will be able to seek treatment from the physician, clinic or hospital of their choice
slide33

BENEFITS/PORTABILITYPatients have unlimited choice of physicians, hospitals, and clinics regardless of locationUSNHI will cover all medically necessary services, including:

  • preventative care
  • primary care
  • inpatient hospital care
  • outpatient care
  • emergency care
  • prescription drugs
  • durable medical equipment
  • long term care
  • mental health services
  • dentistry
  • eye care
  • substance abuse treatment
covering everyone and saving money
COVERING EVERYONE AND SAVING MONEY

Additional costs

Covering the uninsured and poorly-insured +7.2%

Elimination of cost-sharing and co-pays +5.1%

Savings

Bulk purchasing of drugs & equipment -2.8%

Reduced hospital administrative costs -1.9%

Reduced physician office costs - 3.6%

Reduced insurance administrative costs -5.3%

Primary care emphasis & reduce fraud -2.2%

Net (Savings)-4.3%

Source: Health Care for All Californians Plan, Lewin Group, 2005

total savings and revenue are enough to cover total spending
TOTAL SAVINGS AND REVENUE ARE ENOUGH TO COVER TOTAL SPENDING
  • Savings $387 billion
  • Revenue:

Existing Revenue $1,305 billion

New Revenue $1,259 billion

TOTAL (Savings and Revenue) $2.951 trillion

TOTAL PROJECTED SPENDING $2.776 trillion

slide37

It is time to end the cruelty inherent in the failed U.S. health care system.

The opportunity exists to restore national dignity and do what every other civilized nation on earth does—take care of its people.

Margaret Flowers and Brigitte Marti

slide38

For more information:

Physicians for a National Health Program

www.pnhp.org (local chapters in Washington, D.C. and Maryland).

Healthcare-Now! www.healthcare-now.org

Healthcare-Now of Maryland www.mdsinglepayer.org

Leadership Conference on Guaranteed Healthcare

www.guaranteedhealthcare4all.org