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Universal Health Care without Private Health Insurance? Single Payer: The Only Affordable, Lifelong, Comprehensive, Quality Health Care Plan for Every American Robert Zarr, MD, MPH, FAAP RLZARR@yahoo.com DC PNHP www.pnhp.org. MY STORY. Sept 22, 2007,at 1pm, I was assaulted
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Universal Health Care without Private Health Insurance?Single Payer: The Only Affordable, Lifelong, Comprehensive, Quality Health Care Plan for Every American Robert Zarr, MD, MPH, FAAPRLZARR@yahoo.comDC PNHPwww.pnhp.org
MY STORY • Sept 22, 2007,at 1pm, I was assaulted • Loss of consciousness • Ambulance ride & ER visit • NO in-network ambulance coverage for my insurance policy? • Monthly bills from DC EMS • After 5 months, insurance finally paid ONLY 75% of transport cost
We are the best at spending the most money to be ranked 37th in health outcomes by WHO!
In summary, private insurance: • Is wasteful ($350 billion a year) • Reduces the buying power of 300 million American purchasers (decreased monopsony) • Reduces transparency of health care system problems and solutions • Does not provide lifetime comprehensive quality health care to any American
Individual & employer mandates, HSAs, High Deductible Plans, Free Market models MORE OF THE SAME = Insanity: Try it the same way every time and expect different results.
READY FOR REAL CHANGE? SINGLE PAYER NATIONAL HEALTH INSURANCE
House Resolution 676: http://thomas.loc.gov/cgi-bin/thomas United States National Health Insurance Act (Expanded and Improved Medicare for All Act)
The 4 principles of single payer: • Access to comprehensive health care is a human right. • The right to choose and change one's physician is fundamental to patient autonomy. • No corporate profit and personal fortune. • In a democracy, the public should set overall health policies.
Single Payer NHI guarantees: • Comprehensive Care • Quality • Choice • Affordability
Single payer NHI would cover every American for all lifetime medically-necessary services: acute, rehabilitative, long term and home care, mental health, dental services, occupational health care, prescription drugs and supplies, and preventive and public health measures
Prescription Drugs and Supplies • NHI would pay for all medically necessary prescription drugs and medical supplies, based on a national formulary • Regional expert panels would establish and regularly update the formulary • NHI would provide all Americans with full coverage for necessary drugs and supplies
Payment for Physicians and Outpatient Care: 3 Options • fee-for-service, or • salaried positions in institutions receiving global budgets, or • salaried positions within group practices or HMOs receiving capitation payments
How Do We Know It Can Be Done? • Every other industrialized nation has a healthcare system that assures health care for all • All spend less than we do; most spend less than half • Most have lower death rates, more accountability, and higher satisfaction • No country has ever adopted single payer, found it to be worse, and switched back
Projected 2010 Health Care Expenditure Comparison of: Current Health Care System to those of National Health Insurance (NHI, Improved and Expanded Medicare for All, HR 676)
Broad Support from: • 92 US Congressional co-sponsors of HR 676 (more than any other bill) • 59% of US physicians • 70,000 medical students • 75,000 nurses • Faith organizations • 2 state governments (Kentucky and N.H. House of Representatives) • U.S. Conference of Mayors • 452 union organizations
Robert Zarr, MD, MPH, FAAP RLZARR@yahoo.com