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1. Health Care Reform Universal Health Care: The Only Solution 29 E Madison Suite 602, Chicago, IL 60602 Phone (312) 782-6006 | Fax: (312) 782-6007

2. PERSPECTIVE:Practical Current system is unsustainable Burden it places on our economy/businesses Private health insurance premiums are  at unsustainable rate of 13%/year – & as much as 25% in some areas of country Coverage is shrinking, as more employers decide to cap their contributions to health insurance & workers find they cannot pay their rapidly growing share Most expensive health care system in the world

3. PERSPECTIVE:Practical Spend twice as much as other developed nations We don’t get more care - Canadians, see their doctors more often & spend more time in hospital We don’t get better results - do worse than most other developed countries on usual measures of health such as life expectancy, infant mortality, immunization rates We still don’t cover everyone – 48.5 million uninsured In sum, our health care system is outrageously expensive, yet inadequate. Why? There’s something enormously inefficient about the way we finance & deliver health care

4. Institute of Medicine ReportSeptember 6, 2012 Us Health System Wastes $750 billion Annually: Unnecessary services- $210 billion Inefficient delivery of care- $130 billionExcessive administrative costs- $190 billion Inflated Prices- $105 billionPrevention failures- $55 billionFraud- $75 billion

5. PERSPECTIVE:Philosophical Health care is : A Human Right A social service distributed according to need Not a commodity distributed according to ability to pay Not a business whose “beneficiaries” are company executives and investors not patients Most Americans believe everyone should have access to good care without financial hardship

6. PERSPECTIVE:Philosophical We are the only developed nation that does not provide comprehensive health care to all its citizens 48.5 million Americans are uninsured Many are underinsured - lack comprehensive coverage, preventive care, long-term care & drug costs 48,000 die a year from lack of coverage Markets are good for many things, but they are not a good way to distribute health care

7. Problem with For-Profit Payers Investor-owned firms compete not by  quality or  costs, but by avoiding unprofitable patients & limiting services Creates paradox of a health care system based on avoiding the sick It generates huge administrative costs, which, along with profits, divert resources from clinical care to demands of business. Doctors & hospitals maintain costly admin staff to deal with bureaucracy Administration consumes 31% of our health care $

8. Who Are the Uninsured?

9. “…,people have access to health care in America. After all, you just go to an emergency room.”Former President George W. Bush

10. America’s Underinsured Proportion of Americans Going Without Care due to Costs, 2005 (skipping doctor visit, specialist appointment, treatment or prescription when needed) Source: Commonwealth Fund Biennial Health Insurance Survey, 2005

11. Medical Bankruptcy Illness & Medical Bills Contributed to 1,000,000 Personal Bankruptcies in 2004. (Half of All Bankruptcies) Had Insurance Source: Himmelstein, Health Affairs 2005 (state estimates provided by author)

12. Health Care Americans Want Guaranteed access Free choice of doctor High quality Affordability Trust & respect

13. Other Industrialized Nations • Have similar demographics • Availability of expensive technology • Rising drug costs • Similar levels of service Why are their costs so much lower?

14. Why are costs lower in other countries? Administrative simplicity Lower prices Higher ratio of primary care to specialists Health planning Global budgets

15. Life Expectancy, 2005

16. Infant Mortality, 2005

17. Source : OECD 2005

18. Growth of Physicians & Administrators1970-2005 Source: Bureau of Labor Statistics & NCHS

19. One-Third of Health Spending is Consumed by Administration Potential Savings: $350 billion per year Enough to Provide Comprehensive Coverage to Everyone Source: Woolhandler, et al, New England Journal of Medicine, August 2003 & Int. Jrnl. Of Hlth. Services, 2004

20. Health Costs’ Growing Share of Employee Benefits Source: Employee Benefit Research Institute, May 2004

21. Lesson #1: Simply Giving More People Existing Private Insurance Policies Is Not Solution: • Current Private Insurance Policies Offer Inadequate Protection. • Any Gains in Coverage Will Be Quickly Offset as Costs Rise & Employers Shed Benefits.

22. Lesson #2: Real Solution to Health Crisis Must Do 2 Things: • Offer coverage more comprehensive than that currently available on the private market. • Control Costs so that Benefits are Sustainable.

23. Only Two Paths to Reform • Preserve Private Insurance Companies & their Waste • Create a National Health Insurance System

24. Single-Payer Benefits • Comprehensive Coverage for all medically necessary services (doctor, hospital, long-term care, mental health, vision, dental, drug, etc.) in a single-tier system. • Free Choice of doctor & hospital. • Health Workers Unleashed from corporate dictates over patient care, and receive equitable payment for all care provided. • Hospitals guaranteed a secure, regular budget.

25. Financing Single-Payer Medicare Single-Payer Health Care Fund $$$ Medicaid Payroll Tax Income Tax Bonus: Negotiated reimbursement for physicians, global budget for hospitals,  primary & preventive care, bulk purchasing of drugs & medical supplies = long term cost control.

26. Funding a National Single-Payer System“Medicare for All” would save billions Based on the work of Gerald Friedman Professor of Economics at the University of Massachusetts-Amherst Dollars & Sense March/April 2012

27. An Unrelenting Climb of Cost Healthcare spending as percent of GDP Friedman, G. Dollars & Sense. March/April 2012

28. 20/20 Vision for 2020 Projected share of GDP on healthcare Current system The difference is insurance company overhead and profits Single Payer Friedman, G. Dollars & Sense. March/April 2012

30. Single Payer Would Cover Everyone And Spend Less $ Billions $142 Increased utilization (especially home health and dental) Covering the uninsured $110 Medicaid Rate Adjustment $74 Government administration ($23B) $153 Health insurance administration $178 Reduced market power (pharma and devices) $215 Admin costs to providers New Costs Savings Friedman, G. Dollars & Sense. March/April 2012

31. Single Payer Would Cover Everyone And Spend Less $ Billions New Costs: $326 B Net savings: $243 Billion New Savings: $569 B Cover everyone with better benefits and spend less. New Costs Savings Friedman, G. Dollars & Sense. March/April 2012

32. Funding for Single Payer in 2013 Dollars in Billions Friedman, G. Dollars & Sense. March/April 2012

33. Changes in Disposable Income Changes in disposable income with single payer by income group With single payer, 95% of Americans would have more money in their pocket. Friedman, G. Dollars & Sense. March/April 2012

34. Subsidy & Individual Mandate Schemes • Substandard Coverage: forces uninsured to buy defective insurance industry products that are already causing families to face bankruptcy & go without needed care. • Unaffordable: Without savings achievable with single-payer, taxes must raised or funds diverted from other needy programs- education, infrastructure, transportation, etc. • Micro-coverage, Macro-costs: Preserves wasteful private insurers & adds yet another layer of state administrative waste. Rather than provide care to uninsured through a relatively efficient program like Medicare, the plan launders tax dollars through wasteful private insurers. • No Realistic Cost Control: Any gains in public coverage will be unsustainable due to rising costs.

35. “Sounds Great, but it’s not politically feasible” • 2/3rds of population want it. • Most (59 percent) of physicians want it. • Business community is now realizing the need for it.

36. Single-Payer: Glen BartonFormer CEO, Caterpillar Inc. (Fortune 100)Past Chairman, Health & Retirement Task Force Business RoundtableRepresents 150 Largest EmployersTotal Assets: $4.0 Trillion “The quickest & simplest solution… is to go to a single-payer system”- Written Testimony to AHCTF, Feb. 1 2006

37. “If done right, health care in America could be dramatically better with true single-payer coverage.” -Ben Brewer, WSJ, April 18, 2006 • “[single-payer] is an idea that's so easy to slam politically yet so sensible for business that only Republicans can sell it! …it may take a Republican President to bless the socialization of health spending we need.” • -Matt Miller, Fortune, April 18, 2006 CNBC / MSN Money • “Think, as a small business, how you could benefit from a single-payer system: you wouldn’t lose potential employees to larger firms that offer more attractive health benefits; health insurance costs would cease to be a line item in your budget. A serious illness befalling you or an employee wouldn’t be a company-wide financial crisis. You might even save money.” • -Joseph Antony, CNBC / MSN Money, Winter 2003

38. The Rising Popularity of National Health Insurance, 1979-2009 Who should provide coverage? CBS News/New York Times Poll February 1st, 2009

39. Is “The Perfect the Enemy of the Good?” • The central flaws of the PPACA law remain the central flaws of our current system • Uncontrolled Costs • Lack of Universal Coverage • Without eliminating the overhead of a patchwork for-profit system we will not achieve the system we deserve- health system reform must be pursued at the same time as quality reform.

40. Is “The Perfect the Enemy of the Good?”The Radical & the Republican “Many of Lincoln’s admirers have painted him as a man who wanted exactly what the abolitionists did but cannily waited for a perfect moment to achieve it. [In fact], radicals like Douglass set an agenda Lincoln gradually adopted as his own. Without abolitionists, there would have been no Lincoln.” - James Oakes, Historian, UC Berkeley

41. Single-Payer: “Politically Feasible?” Other “Politically Infeasible” Movements • Abolition of Human Slavery (1860s) • Women’s Suffrage Movement (1840-1920) • Civil Rights Act (1964) • Voting Rights Act (1965)