Health Care Reform Universal Health Care The Only

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

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

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

Institute of Medicine Report September 6, 2012 Us Health System Wastes $750 billion Annually: Unnecessary services- $210 billion Inefficient delivery of care- $130 billion Excessive administrative costs- $190 billion Inflated Prices- $105 billion Prevention failures- $55 billion Fraud- $75 billion

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

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

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 $

Who Are the Uninsured?

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

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

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

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

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

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

Life Expectancy, 2005

Infant Mortality, 2005

Source : OECD 2005

Growth of Physicians & Administrators 1970 -2005 Source: Bureau of Labor Statistics & NCHS

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

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

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.

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.

Only Two Paths to Reform 1. Preserve Private Insurance Companies & their Waste 2. Create a National Health Insurance System

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.

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

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

An Unrelenting Climb of Cost 20% Healthcare spending 16% as percent of GDP 12% 8% 4% 1960 1970 1980 1990 2000 2010 Friedman, G. Dollars & Sense. March/April 2012

20/20 Vision for 2020 20% Projected share of 16% GDP on healthcare Current system The difference is insurance company overhead and profits 12% 8% Single Payer 4% 2013 2014 2015 2016 2017 2018 2019 2020 Friedman, G. Dollars & Sense. March/April 2012

Single Payer Would Cover Everyone And Spend Less $ Billions $200 0 -$200 -$400 -$600 $142 Increased utilization (especially home health and dental) $110 $74 Covering the uninsured Medicaid Rate Adjustment Government administration ($23 B) $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

Single Payer Would Cover Everyone And Spend Less $ Billions $200 New Costs: $326 B Net savings: 0 -$200 -$400 -$600 New Savings : $569 B $243 Billion Cover everyone with better benefits and spend less. New Costs Savings Friedman, G. Dollars & Sense. March/April 2012

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

Changes in Disposable Income 15% 10% Changes in disposable 5% income with single 0 payer by income -5% group -10% With single payer, 95% of Americans would have more money in their pocket. -15% Lowest Secon -20% d 20% Middle Fourth 20% Next 15% Next 4% Top 1% Friedman, G. Dollars & Sense. March/April 2012

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.

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

Single-Payer: Glen Barton Former CEO, Caterpillar Inc. (Fortune 100) Past Chairman, Health & Retirement Task Force Business Roundtable Represents 150 Largest Employers Total Assets: $4. 0 Trillion “The quickest & simplest solution… is to go to a single-payer system” - Written Testimony to AHCTF, Feb. 1 2006

“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 companywide financial crisis. You might even save money. ” -Joseph Antony, CNBC / MSN Money, Winter 2003

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

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 forprofit system we will not achieve the system we deserve- health system reform must be pursued at the same time as quality reform.

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

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