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U.S. Health System Reform Rhetoric vs. Reality. Joseph M. Heyman, MD Chair, Board of Trustees. Where does insurance come from?. Employer-sponsored 61%. Private/ Non-group 5%. Uninsured 18%. Medicaid/ Public Health Insurance 16%. Family health coverage in MI. Cutting back on care.

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u s health system reform rhetoric vs reality

U.S. Health System ReformRhetoric vs. Reality

Joseph M. Heyman, MD

Chair, Board of Trustees


Where does insurance come from?









Public Health Insurance


u s health care spending
U.S. Health Care Spending

2018: $4.4 Trillion

2008: $2.4 Trillion



American College of Physicians, Ann Intern Med 2008;148:55-7


Percentage of national health expenditures spent on health administration, 2003

American College of Physicians, Ann Intern Med 2008;148:55-75

support for health system reform
Support for Health System Reform

“We can no longer afford to put health care reform on hold.”

~ President Barack Obama, Feb. 24, 2009

“Rising health costs undermine our strength in the global marketplace.”

~ Sens. Baucus and Kennedy, Feb. 26, 2009 WSJ

“We can achieve health-care reform in America . . . if we do it in a truly bipartisan basis.”

~ Sen. John McCain, Feb. 25, 2009, CNN


“You have our commitment to play, to contribute and to help pass healthcare reform this year.”

~ AHIP Chief Executive Karen Ignagni, at the Obama health care summit, March 5, 2009

ama working closely with
AMA working closely with:
  • Obama Administration
  • Senate HELP and Finance
  • House Ways and Means; Energy and Commerce
  • Health Reform Dialogue Group
  • State attorneys general
  • State medical societies
health system reform
Health System Reform
  • Provide health care coverage for all
  • Improve quality
  • Promote wellness and prevention
  • Reform public programs
  • Reform health care delivery systems
  • Reduce cost and increase value
the ama plan
The AMA Plan
  • Affordability
  • Choice
  • Fairness
annual costs of chronic disease
Annual costs of chronic disease
  • Heart disease and stroke $448B
  • Smoking and tobacco use $193B
  • Diabetes $174B
  • Obesity $117B
  • Cancer $89B
  • Arthritis $81B
  • Pregnancy complications $1B
  • (pre-delivery)Total = $1.1Trillion

Source: http://www.cdc.gov/nccdphp/overview.htm

the medicare dilemma
The Medicare Dilemma

Practice Costs

Medicare Cuts

stimulus rhetoric vs reality
Stimulus Rhetoric vs. Reality
  • Health Information Technology (HIT)
  • Comparative Effectiveness Research (CER)
  • The first step toward

health system reform

  • www.ama-assn.org/go/patients