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Health Care in Obama’s 1st Year or More of the Same is not  Health Care Reform  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why Health Care Is On the Agenda: Escalating Cost Average Annual Premiums for Single and Family Coverage, 1999-2008 Source:  Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2008.
International Comparison: Universal Coverage at Less Cost -- They Must Be Doing Something Right! * PPP = Purchasing Power Parity. Data: OECD Health Data 2008, June 2008 version. Average spending on health per capita ($US PPP*) None rely on private for-profit insurance, all have a strong role for government.
High Cost of Health Insurance Premiums: Even the Middle Class Can No Longer Afford It ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Epidemic of Underinsurance Source:   Too Great a Burden , Families USA, December 2007 Number of people spending more than 10% of income  on health care (Millions)
Medical costs create serious financial problems for millions of us Source: Health Tracking Poll, Kaiser Family Foundation, April 2008
Health Care Costs Are Concentrated Among a Few People in Any One Year This Year’s Underinsured Source: Medical Expenditure Panel Survey, US Agency for Healthcare Research and Quality, 1999 Percent of  Health  Care Costs While millions are underinsured,  millions more don’t think there’s a problem!
The President’s Principles for Health Care Reform ,[object Object],[object Object],[object Object],[object Object],[object Object],-- “A New Era of Responsibility,” President’s Budget, Feb. 26, 2009
The Progress of US Health Care Reform Employer mandate Public option** Individual mandate* * “each eligible individual must enroll in an applicable health plan for the individual and must pay any premium required with respect to such enrollment.” (S.1775) ** “you can choose to enroll in the new public plan”
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],The Mandate Model
The Obama/Congressional Plan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Massachusetts Plan: Insurance Still Costly and Unaffordable * Also physician & hospital co-pays Source: www.mahealthconnector.org (Boston Area, Jan 2009) Family Characteristics Annual Income Annual Cost Deductible* 30-year old individual $31,212 or more $2,459 $2,000 30-yr old couple w/2 children $63,612 or more $8,900 $3,500 55-year old couple $42,012 or more $10,476 $4,000
Why a Public Option? ,[object Object],[object Object],[object Object],[object Object],Source: Jacob Hacker,  Healthy Competition , Berkeley Law and Institute for America’s Future, April 2009,  Howard Dean, Barack Obama
Why Not a Public Option? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What Happened to the Public Plan?   The Original “robust” Plan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What Will Control Costs under the Congressional Plan? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Covering the Uninsured and the Underinsured? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Senate Finance Committee Considers How to Pay for HCR $400B ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],The Invisible Pot of Gold! Senate Finance Committee Considers How to Pay for Health Care Reform
Will the Mandate Plan Pass? ,[object Object],[object Object],[object Object],[object Object]
The Bottom Line on the Congressional Plan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conyers: Expanded and Improved Medicare for All “single payer national health care” HR 676 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
New  – Sanders (& McDermott): American Health Security Act   S 703 (HR 1200) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How We Pay for Health Care Today Private Insurance 34% Out of pocket 12% Other private funds (charity, etc.) 7% State and Local Government (existing Medicaid, other) 13% Federal Government (existing Medicare, Medicaid, other) 34% Source:  Health Affairs , Feb. 2008; data for 2006
How Single Payer Could Be Paid For:  One Example from a Recent Study of a California Plan Note: Payroll and income taxes between $7,000 and $200,000 only.  Source: Health Care for All Californians Act: Cost and Economic Impacts Analysis, The Lewin Group, January 2005
Billing and Insurance: Nearly 30% of All Health Care Spending 28% Source: James G. Kahn et al,  The Cost of Health Insurance Administration in California: Estimates for Insurers, Physicians, and Hospitals , Health Affairs,  2005 Allocation of Spending for Hospital and Physician Care Paid through Private Insurers
Covering Everyone with  No Additional Spending ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source: Health Care for All Californians Plan, Lewin Group, January 2005 134 107 241   -21  -76 -111 -59 -46   -313 $ B Total Costs  +11.5% Total Savings  -15.8% Net Savings  - 4.3%  - 73
Single payer offers real tools to contain costs ,[object Object],[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object],[object Object],We don’t need more money. We need a new system. -- Arnold Relman & Marcia Angell
We Can’t Wait Another 16 Years! Will We Get  Real  Health Care Reform Before the Premium Takes All our Income? Source:  American Family Physician,  November 14, 2005 Today

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Healthcare

  • 1.
  • 2. Why Health Care Is On the Agenda: Escalating Cost Average Annual Premiums for Single and Family Coverage, 1999-2008 Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2008.
  • 3. International Comparison: Universal Coverage at Less Cost -- They Must Be Doing Something Right! * PPP = Purchasing Power Parity. Data: OECD Health Data 2008, June 2008 version. Average spending on health per capita ($US PPP*) None rely on private for-profit insurance, all have a strong role for government.
  • 4.
  • 5. The Epidemic of Underinsurance Source: Too Great a Burden , Families USA, December 2007 Number of people spending more than 10% of income on health care (Millions)
  • 6. Medical costs create serious financial problems for millions of us Source: Health Tracking Poll, Kaiser Family Foundation, April 2008
  • 7. Health Care Costs Are Concentrated Among a Few People in Any One Year This Year’s Underinsured Source: Medical Expenditure Panel Survey, US Agency for Healthcare Research and Quality, 1999 Percent of Health Care Costs While millions are underinsured, millions more don’t think there’s a problem!
  • 8.
  • 9. The Progress of US Health Care Reform Employer mandate Public option** Individual mandate* * “each eligible individual must enroll in an applicable health plan for the individual and must pay any premium required with respect to such enrollment.” (S.1775) ** “you can choose to enroll in the new public plan”
  • 10.
  • 11.
  • 12. The Massachusetts Plan: Insurance Still Costly and Unaffordable * Also physician & hospital co-pays Source: www.mahealthconnector.org (Boston Area, Jan 2009) Family Characteristics Annual Income Annual Cost Deductible* 30-year old individual $31,212 or more $2,459 $2,000 30-yr old couple w/2 children $63,612 or more $8,900 $3,500 55-year old couple $42,012 or more $10,476 $4,000
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23. How We Pay for Health Care Today Private Insurance 34% Out of pocket 12% Other private funds (charity, etc.) 7% State and Local Government (existing Medicaid, other) 13% Federal Government (existing Medicare, Medicaid, other) 34% Source: Health Affairs , Feb. 2008; data for 2006
  • 24. How Single Payer Could Be Paid For: One Example from a Recent Study of a California Plan Note: Payroll and income taxes between $7,000 and $200,000 only. Source: Health Care for All Californians Act: Cost and Economic Impacts Analysis, The Lewin Group, January 2005
  • 25. Billing and Insurance: Nearly 30% of All Health Care Spending 28% Source: James G. Kahn et al, The Cost of Health Insurance Administration in California: Estimates for Insurers, Physicians, and Hospitals , Health Affairs, 2005 Allocation of Spending for Hospital and Physician Care Paid through Private Insurers
  • 26.
  • 27.
  • 28.
  • 29. We Can’t Wait Another 16 Years! Will We Get Real Health Care Reform Before the Premium Takes All our Income? Source: American Family Physician, November 14, 2005 Today

Notas del editor

  1. This graph shows a population divided into 10ths. It shows how health care services are utilized in any one year in any population. Take even 1000 people in a population and you will find that the majority of them (80%) are healthy and use very little care. 30% of them in fact, use no care at all!. In actuality most of the services are used in any one year by a small percentage. 10% use 72 % of the health care dollar.If we add to that the 10% who use 13% of the care we find that 20% use 86% of health care services. It is worth keeping in mind that these are not the same people all the time. All of us move in and out of this group at one or many times in our lives. And when we are in that group ( birth of a baby, coronary bypass, cancer diagnosis) we expect health care services to be there waiting for us. Health care is not like other human needs. We all have the same basic needs for food. shelter, clothing etc. When you look at the population’s needs in regard to health care needs are vastly different. Because at any one time the healthy majority use very little care - 80% of the population in Vermont use only 14% of the health care dollar. On the other hand, 10% use 73%of the health care dollar.. Another important point is that the most expensive services The NICU, the trauma unit, dialysis to name a few are used by a very small number of people. Dialysis is used by only 380 people per year in Vermont. Yet the infrastructure costs of sustaining these services are enormous.