healthcare reform: we're still for it, and we're not done yet!

HEALTHCARE REFORM 2010 : 

HEALTHCARE REFORM 2010 WE’RE STILL FOR IT, AND WE’RE NOT DONE YET Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Assistant Professor of Emergency Medicine, IUSM

DISCLOSURES : 

DISCLOSURES Dr. Rob Stone has no relevant financial relationships with commercial interests. Slides can be downloaded at: HCHP.info/Presentations

Lack of Insurance Kills : 

Lack of Insurance Kills 1 every 12 minutes 120 every day 45,000 a year People without insurance: Live sicker and die younger The safety net is full of holes American Journal Public Health, Wilper et al, Dec 2009

Insurance Premiums • Workers’ Earnings • Inflation 1999-2008 : 

Insurance Premiums • Workers’ Earnings • Inflation 1999-2008 Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2000-2008. Bureau of Labor Statistics, Consumer Price Index

Bankruptcy 2009 : 

Bankruptcy 2009 62% caused by illness and medical bills Most were middle class 78% were insured when they became ill Himmelstein et al, American Journal of Medicine, August 2009

Slide 9: 

Health Spending Per Capita Rampel, US Health Spending Breaks From the Pack, NYT 7/8/09

What Are We Paying For? : 

What Are We Paying For? An incredibly complex system Thousands of plans Armies of people to: -deny coverage and payments - collect payments - determine eligibility

Slide 12: 

Where is the bureaucratic nightmare?

U.S. Overhead Spending : 

U.S. Overhead Spending International Journal of Health Services 2005; 35(1): 64-90

Medicare’s Efficiency: 3% Overhead : 

Medicare’s Efficiency: 3% Overhead 2003, 31% health spending on overhead – could save $286 Billion1 1993, CBO: “The net cost of Single Payer would be negative.”2 1991, GAO: “If US shifted to coverage like Canada, savings would offset the expense of universal coverage”3 1New England Journal of Medicine 8/21/2003 2Congressional Budget Office, 1993, 3 separate reports 3General Accounting Office, 06/91 ref: T-HRD-91-35

Slide 15: 

“Kids, your mother and I have spent so much money on health insurance this year that instead of vacation, we’re all going in for elective surgery.”

Brief History : 

Brief History WWII: Wage and price controls 1947: Truman pushes for National Health Insurance AMA and Southern legislators oppose

History (continued) : 

History (continued) The birth of the Blues 1965: Medicare and Medicaid 1993: Clinton Health Plan Death of not-for-profit insurance

Anthem /WellPoint(formerly Blue Cross) : 

Anthem /WellPoint(formerly Blue Cross) CEO Larry Glasscock in Indianapolis, just retired Bonus in 2003 - $42.5 Million Indianapolis Star 4/7/04

What Do We Get For Our Money? : 

What Do We Get For Our Money? The most expensive health care in the world The best health care in the world?

WHO Global Health Rankings : 

WHO Global Health Rankings At the top: France is #1 US ranks 37th, between Costa Rica and Slovenia

Elderly as Percent of Total Population : 

Elderly as Percent of Total Population

Tobacco Smokers : 

Tobacco Smokers OECD, 2004 (2002 Data, U.K is 2001)

MRI Units per Million People : 

MRI Units per Million People OECD, 2004 (2002 Data, U.S., Canada, and Germany are 2001)

Why spend so much AND get so little? : 

Why spend so much AND get so little? Reason # 1: Our profit-driven insurance system AND As long as millions are left out, everyone will suffer

Myths : 

Myths Our “system” is fine, just needs band-aids The safety net We can’t afford to cover everyone The best health care system in the world

Slide 31: 

International Timeline of Universal Healthcare Germany 1883 Switzerland 1911 New Zealand 1938 France 1945 United Kingdom 1946 Sweden 1947 USA 1947* Japan 1961 Canada 1966 Australia 1974 Italy 1978 Spain 1986 Taiwan 1995 *President Truman proposed but failed to pass National Health Insurance

Myth Versus Reality : 

Myth Versus Reality Every wealthy democracy has A National Program of Health Care For All Socialized Medicine versus Single Payer

The Medical-Industrial Complex : 

The Medical-Industrial Complex “Remember that what the rest of us call health care costs, they call income.” - Paul Krugman, Nobel Laureate New York Times 5/10/09

The Best Democracy Money Can Buy? : 

The Best Democracy Money Can Buy? Health industry spending - $396 million on lobbying in 20091 13 health lobbyists per member of Congress2 Senate Bill authored by Liz Fowler, former WellPoint VP 1The Center for Responsive Politics 2American League of Lobbyists

Is PPACA a Step in the Right Direction?Will Insurance Companies become: : 

Is PPACA a Step in the Right Direction?Will Insurance Companies become: Stronger? Millions of new mandated customers $358 B taxpayer subsidy for premiums Insufficient industry regulation Lack of real cost controls More vulnerable? Anger over mandates Loss of $136 B Medicare Advantage subsidies New regs will expose them to risk Run away costs will make Medicare for All inevitable

Is PPACA a Step in the Right Direction? : 

Is PPACA a Step in the Right Direction? The Good Government is responsible for the uninsured 30-35 million covered Progressive taxation $10 B for Community Health Centers The Bad Private Insurance model retained 20-25 million left uncovered Taxpayers subsidize stockholders $36 B from safety net hospitals

Slide 39: 

Our Non-System of Illness Care

Why Health Care for All - Young and Old, Rich and Poor? : 

Why Health Care for All - Young and Old, Rich and Poor?

What Can We Do? : 

What Can We Do? Educate Ourselves Find Our Voices Join In

Slide 42: 

HCHP.info

Slide 43: 

PHYSICIANS FOR A NATIONAL HEALTH PROGRAM PNHP.org