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Conversation Coalition For Health Care Reform

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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Conversation Coalition For Health Care Reform

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  1. Conversation Coalition For Health Care Reform

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

  3. 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.

  4. 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

  5. THE RESULT: • The United States is one of three industrialized nations that does not have a HEALTH CARE SYSTEM

  6. 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

  7. SPENDING TOO MUCH • We spend two times more and cover less; fewer benefits and fewer people

  8. 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

  9. 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.

  10. 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)

  11. 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

  12. 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.

  13. 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

  14. 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)

  15. Administration is the Fastest Growing job in Health Care Source: Bureau of Labor Statistics and NCHS

  16. 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

  17. 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

  18. WHAT’S WRONG WITH THIS PICTURE? Premiums are rising five times faster than inflation

  19. THE CYCLE CONTINUES UNTIL … UNINSURED

  20. HEALTH INSURANCE IS LOST

  21. 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

  22. 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.

  23. INCREMENTAL (BANDAID) REFORMS DON’T WORK

  24. THE LATEST “FIX”: MASSACHUSETTS Percent of previously uninsured newly covered as of 11/1/07, calculated from CPS

  25. 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.

  26. 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

  27. DO YOU HAVE YOUR FIRE INSURANCE CARD?

  28. 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

  29. 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

  30. 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

  31. 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

  32. 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

  33. 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

  34. 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

  35. Independent Analysis: Single Payer Saves a Trillion Dollars!

  36. 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

  37. 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

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