The PNHP Vision for National Health Insurance in the United States. Oliver Fein, M.D. , Chair Physicians for a National Health Program Metro NY. The PNHP Program for NHI. What will the delivery system look like?
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Oliver Fein, M.D., Chair
Physicians for a National Health Program Metro NY
What will the delivery system look like?
What will the insurance system look like?
immigrants, and the undocumented
“Everybody in, nobody out”
Universal coverage means more than who is
covered, it means the same coverage for
Universal coverage means no more tiering
in health care
Benefits will cover “All medically necessary services” including:
Will there be any exclusions?
How will the inclusions/exclusions be
Why is the Program called “single payer” NHI?
costs: Medicare=2-3% vs private insurance=16-30%
the care of patients: 97% for Medicare; 70-84% for private insurance.
How do we pay for single payer NHI?
equals 1.45% from employee + 1.45% from the
Can we afford single payer NHI?
(1500 private insurers) amounts to $298 billion/year. (NEJM August 21, 2003)
we will save $298 billion/year
Money Spent Per Capita on Administrative Costs
(includes insurance, hospital and physician administrative costs)
Source: “Administrative Waste in the U.S. Health Care System,” Woolhandler, Himmelstein & Wolfe
Growth in Physicians and Administrators since 1970
Source: BLS & Himmelstein/Woolhandler/Lewontin Analysis of CPS Data
Source: USA Today/Harris Poll - 11/23/98
Having Medicare cover long-term
Nursing home care “even if it means
higher premiums or taxes”
Having Medicare cover prescription
Drugs “even if it means higher premiums
Expansion of Medicare so that people
Aged 62-64 are able to buy into the
program before they turn 65
Source: Kaiser Family Foundation/Harvard School of Public Health National Survey on Medicare, 10/20/98 (conducted Aug-Sept 1998)
Per Capita Health Spending, 2002
OECD and “Paying for National Health Insurance—And Not Getting It”
Health Affairs: July / August 2003
Single-payer National Health Insurance
3. Incremental Reforms
4. Defensive Fights
5. Reactive Fights
Common Sense: “You cannot cross a chasm in two jumps”