Massachusetts Single Payer 101 Training

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This is a training to introduce audiences to the problems with the health care system in Massachusetts, and to describe how a single payer health care system controls costs and saves lives elsewhere in the world.

Salud y medicina

Single Payer 101 Training
Universal Health Care for Massachusetts

http://masscare.org

What’s Wrong With Our
Health Care System?
(the easy part)

U.S. Has Lowest Life Expectancy
in the Industrialized World

OECD, 2011

U.S. Has Among Highest
Infant Mortality Rates

Health, United States, 2007

U.S. Has Among Highest
Maternal Mortality Rates

OECD, 2011

Human Toll of Uninsurance
1987 = Uninsured 25% more likely to
die than the insured

2005 = Uninsured 40% more likely to
die than the insured

United States = 45,000 deaths due to
lack of insurance in 2005

Insurance Coverage Better in
Massachusetts, but Unsustainable

Rapid Growth of “Underinsured”
Households

Insurance Not Protection Against
Health Care Costs (2010)

Most Medically Bankrupt Had
Insurance at Onset of Illness

No Change in Mass. Medical Debt
and Medical Bankruptcies

Rising Share of Mass. Residents
with High Deductibles ($1,000+)

Large Inequities Remain in
Mass. Insurance Coverage

Little Change in Mass. Inequities in
Cost Barriers to Care

U.S. Spends Almost Double Next
Highest Spending Country

U.S. Health Care System the Sixth
Largest Economy in the World
Country 2010 GDP
United States $14,447,100
China $5,739,358
Japan $5,458,873
Germany $3,280,334
France $2,559,850
U.S. Health Care System $2,542,690
United Kingdom $2,253,552

Health Care Spending Will Consume
the Entire Economy by 2052

Health Care Costs Responsible
for the Federal Deficit

State Health Spending is Edging
Out All Other Public Programs

City of Boston Salaries Falling,
Health Care & Pension Costs Rising

City of Boston Salaries Falling,
Health Care & Pension Costs Rising

1,105 (6.5%) jobs cut from January 2009 to 2012

100% of Minimum Wage Salary
to Pay for a Family Health Plan

Growing % of Mass. Families with
Unaffordable Health Care Costs

Over Half of Home Foreclosures
Due to Medical Causes

Why Are U.S. Health Care
Costs So High?
(the hard part)

Common Explanations for
High Health Care Costs

Disease Prevalence:
U.S. vs. Peer Countries

Disease Prevalence:
U.S. vs. Peer Countries

Disease
prevalence
=
$57 to $70
billion savings

What’s Driving U.S. Prices?

(the easy part
that’s hard to win)

Nations With Universal
Health Care Coverage

How Single Payer
Health Care Is Paid For

Fixed Payroll Tax Negotiated Budget
Government Health Care
You Fund Providers

How U.S. Health Care
Is Paid For
Medicaid
Taxes Medicare
Separate contracts
Blue Cross
Premiums Tufts Medical Insurance

You Out-of-Pocket Costs

Health Care
Providers

Insurance Administration Costs

OECD Data, 2010

Hospital Administration Costs

OECD, 2010

Aortic Aneurysm Repair Costs

Brox. et. al. Arch Internal Medicine, 2003

U.S. Pays Higher Prices for
the Same Drugs

mt.gov.com, 2010

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Chapter 2 Where Are We? American health care is in a state of flux as new scientific knowledge and clinical experience continue to change our definitions of illness and wellness. As a society, we respond by changing the ways health care is delivered. Health services increasingly impact our society—from health status to employment to budgetary economics to recreation to professional concerns to our perceptions of our own well-being. American health care is also in flux because now that it has grown to more than one-sixth of our economy it threatens to squeeze out public goods such as education and infrastructure maintenance. People have wanted to do something about cost and access to care problems for a long time. The 2010 Affordable Care Act (ACA) is doing much to address access issues, but opposition to certain provisions is strong. Employers are steadily shifting more risk to employees and their families, and there is a real tension between Washington and the state capitols over Medicaid expansion. Medicare trust funds are forecast to disappear over the next decade or so. Washington is unlikely to tolerate another major health reform battle, although major changes may come as a side effect of a “grand” government overhaul of spending and tax policies. The future is highly uncertain, and still we must plan and act as we go along. This chapter reviews the current status of the U.S. health care system from several points of view: • Current outcomes and costs • Quality • Leadership • Complexity • Industrializing structures for delivery • Medicalization of our society • Redistribution of wealth 2.1 Current Outcomes and Costs Previous section Next section 2.1 CURRENT OUTCOMES AND COSTS Health care expenditures were projected to rise to close to 20% of the U.S. gross domestic product (GDP) by 2015 (Borger et al., 2006), but more recent estimates from the Centers for Medicare & Medicaid Services (CMS) project it to be 18.2% for 2015 and 19.5% by 2021 (CMS, 2012). Average annual family health insurance premiums were estimated for 2012 at $15,745, with $11,429 paid by employers. The 4% growth rate for 2012 was slow by historical standards but still more than twice the growth rate of wage income. The comparable total insurance cost for a single individual was $5,615. Large employers (98%) offered health care benefits to workers but were cutting back on retiree health benefits. Only 50% of firms with 3 to 9 workers and 73% with 10 to 24 workers offered health benefits. Many small companies do not provide health benefits. At the same time, control of health care by health professionals is being threatened by outsiders calling for more reliance on government programs, more consumer-centered care, or both. High Comparative Costs and Low Comparative Outcomes The United States spends far more on health care per capita and as a percentage of GDP than other developed countries, yet does not seem to be much better off for it. Table 2-1 illustrates this ...

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Online Journal of Health Ethics Volume 1 | Issue 1 Article 5 Universal Healthcare in America Sandra Carr Hayes University of Mississippi Medical Center Follow this and additional works at: http://aquila.usm.edu/ojhe This Article is brought to you for free and open access by The Aquila Digital Community. It has been accepted for inclusion in Online Journal of Health Ethics by an authorized administrator of The Aquila Digital Community. For more information, please contact [email protected] Recommended Citation Hayes, S. C. (2004). Universal Healthcare in America. Online Journal of Health Ethics, 1(1). http://dx.doi.org/10.18785/ojhe.0101.05 http://aquila.usm.edu/ojhe?utm_source=aquila.usm.edu%2Fojhe%2Fvol1%2Fiss1%2F5&utm_medium=PDF&utm_campaign=PDFCoverPages http://aquila.usm.edu/ojhe/vol1?utm_source=aquila.usm.edu%2Fojhe%2Fvol1%2Fiss1%2F5&utm_medium=PDF&utm_campaign=PDFCoverPages http://aquila.usm.edu/ojhe/vol1/iss1?utm_source=aquila.usm.edu%2Fojhe%2Fvol1%2Fiss1%2F5&utm_medium=PDF&utm_campaign=PDFCoverPages http://aquila.usm.edu/ojhe/vol1/iss1/5?utm_source=aquila.usm.edu%2Fojhe%2Fvol1%2Fiss1%2F5&utm_medium=PDF&utm_campaign=PDFCoverPages http://aquila.usm.edu/ojhe?utm_source=aquila.usm.edu%2Fojhe%2Fvol1%2Fiss1%2F5&utm_medium=PDF&utm_campaign=PDFCoverPages http://dx.doi.org/10.18785/ojhe.0101.05 mailto:[email protected] Universal Healthcare 1 Universal Healthcare in America Sandra Carr Hayes University of Mississippi Medical Center Keywords: Health care; Universal Healthcare; Healthcare Access; National Health; Health Costs Abstract Lack of health care insurance, once thought to be a problem of the poor, and has now begun to affect a new population- the middle class. The major factors contributing to this are increased deductibles and co-payments, cost shifting and the introduction of managed care networks. The idea of a universal health plan has been introduced several times over the last few decades. With the introduction of Medicare and Medicaid came the promise of a more inclusive health care plan for all Americans. However, Medicare and Medicaid remain largely unchanged from what they were when they were first introduced in 1965. The U. S. was built on the foundation of ‘unalienable rights’. Why then is the number of uninsured and uninsured rising and projected to continue rising? This article seeks to explore these questions. Universal Healthcare 2 Universal Healthcare in America Introduction One in six Americans doesn’t have health insurance. Studies have shown that health insurance and poverty are the strongest determinants of access to health services (Guendelman, et. al, 1986). The uninsured are less likely to obtain medical attention when they have a perceived "need for care". This is best illustrated in the case of George and Tina. George and Tina were siblings who had been diagnosed with diabetes in childhood. However, their disease went un.

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Running Head: UNIVERSAL HEATH CARE 1 UNIVERSAL HEATH CARE 5 Universal Healthcare Tasha Smith Zachary Martin 04/16/2016 Universal Health Care Universal healthcare has had significant reforms. One of the significant changes is the provision of free healthcare. It is an undeniable fact that the provision of free health services has some benefits. The benefits of provision of free universal healthcare include improved health care to people. Universal healthcare provides accessible health services to the population in different regions in the world. Universal health care has reduced high poverty levels. Poor people can access specialized treatment such as cancer. Universal health care has seen the majority population seek preventive care to avert the occurrence of diseases such as cancer. Another advantage is that universal health care coverage promotes equality and fairness. Irrespective of income or wealth, every person can access health care services in any part of the world. Universal health care coverage leads to decrease in healthcare administrative costs. This is a positive impact on the healthcare organizations. A single body has undertaken all administrative activities such as billing and insurance payouts. Universal healthcare has led to economic growth and better living standards since population does not spend much money paying for health care services. The money that could have been used for healthcare services have been put in income generating activities such as business resulting in economic growth and development and improved standards of living of the general population. However, they are various disadvantages of having universal health care. Several experts have studied the cons of universal healthcare. They argue out that universal healthcare reduces standards of healthcare. The paper presents an argument that denies the notion that universal health care should be available and free to every person. Universal healthcare coverage should not be provided to all patients because it results in adverse implications such as long waiting time, socialism state as well as an increased government time. Long Wait Time This type of healthcare system results in patients waiting for long to be served by medical practitioners. The numbers of patients are many, congesting hospitals, clinics, sanatoriums, and dispensaries. The system then becomes slow and tedious for the few hospital workers. Long wait time causes weak submission of services, poor sanitation and hence degrading overall value of health care. A patient may go the emergency room with an emergency but kept waiting because of a patient who came earlier with a less severe medical condition, for example, the flu. (Niles, 2014) Leads to Socialism State A socialism state refers to a state whereby people work and are forced to share their earnings with people who may not be working. Universal health care would require the government to raise ...

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1. Single Payer 101 Training Universal Health Care for Massachusetts http://masscare.org

2. What’s Wrong With Our Health Care System? (the easy part)

3. U.S. Has Lowest Life Expectancy in the Industrialized World OECD, 2011

4. U.S. Has Among Highest Infant Mortality Rates Health, United States, 2007

5. U.S. Has Among Highest Maternal Mortality Rates OECD, 2011

6. Rising Uninsured Population

7. Human Toll of Uninsurance 1987 = Uninsured 25% more likely to die than the insured 2005 = Uninsured 40% more likely to die than the insured United States = 45,000 deaths due to lack of insurance in 2005

8. Insurance Coverage Better in Massachusetts, but Unsustainable

9. Rapid Growth of “Underinsured” Households

10. Insurance Not Protection Against Health Care Costs (2010)

11. Most Medically Bankrupt Had Insurance at Onset of Illness

12. No Change in Mass. Medical Debt and Medical Bankruptcies

13. Rising Share of Mass. Residents with High Deductibles ($1,000+)

14. Large Inequities Remain in Mass. Insurance Coverage

15. Little Change in Mass. Inequities in Cost Barriers to Care

16. U.S. Spends Almost Double Next Highest Spending Country

17. U.S. Health Care System the Sixth Largest Economy in the World Country 2010 GDP United States $14,447,100 China $5,739,358 Japan $5,458,873 Germany $3,280,334 France $2,559,850 U.S. Health Care System $2,542,690 United Kingdom $2,253,552

18. Health Care Spending Will Consume the Entire Economy by 2052

19. Health Care Costs Responsible for the Federal Deficit

20. State Health Spending is Edging Out All Other Public Programs

21. City of Boston Salaries Falling, Health Care & Pension Costs Rising

22. City of Boston Salaries Falling, Health Care & Pension Costs Rising 1,105 (6.5%) jobs cut from January 2009 to 2012

23.

24. 100% of Minimum Wage Salary to Pay for a Family Health Plan

25. Growing % of Mass. Families with Unaffordable Health Care Costs

26. Over Half of Home Foreclosures Due to Medical Causes

27. Why Are U.S. Health Care Costs So High? (the hard part)

28. Common Explanations for High Health Care Costs

29. Common Explanations for High Health Care Costs

30. Common Explanations for High Health Care Costs

31. Common Explanations for High Health Care Costs

32. Disease Prevalence: U.S. vs. Peer Countries

33. Disease Prevalence: U.S. vs. Peer Countries Disease prevalence = $57 to $70 billion savings

34.

35.

36.

37.

38. What’s Driving U.S. Prices? (the easy part that’s hard to win)

39. Nations With Universal Health Care Coverage

40. How Single Payer Health Care Is Paid For Fixed Payroll Tax Negotiated Budget Government Health Care You Fund Providers

41. How U.S. Health Care Is Paid For Medicaid Taxes Medicare Separate contracts Blue Cross Premiums Tufts Medical Insurance You Out-of-Pocket Costs Health Care Providers

42. Insurance Administration Costs OECD Data, 2010

43. Hospital Administration Costs OECD, 2010

44. Aortic Aneurysm Repair Costs Brox. et. al. Arch Internal Medicine, 2003

45. U.S. Pays Higher Prices for the Same Drugs mt.gov.com, 2010

Notas del editor

OECD 2011
GDP estimates for 2010 from the United Nations; U.S. health care costs from OECD. http://unstats.un.org/unsd/snaama/dnltransfer.asp?fID=2 http://www.oecd.org/document/60/0,3746,en_2649_33929_2085200_1_1_1_1,00.html
From “7 Things You Need to Know About the National Debt, Deficits, and the Dollar,” Dean Baker and David Rosnick, Center for Economic and Policy Research, June 2011.
Higher wages No threat to healthcare coverage when switching jobs Expanded job opportunities due to level playing field Health care coverage removed from bargaining table Part-time workers insured
From “Affording Health Care and Education on the Minimum Wage,” John Schmitt and Marie-Eve Augier, Center for Economic and Policy Research, March 2012.
Represents $57 to $70 billion in savings due to lower disease prevalence.
Represents $57 to $70 billion in savings due to lower disease prevalence.
Separately negotiated budgets
PNHP

Massachusetts Single Payer 101 Training

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