For Patients, Not for Profits A SinglePayer National Health Insurance Program HR 676

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For Patients, Not for ProfitsA Single-Payer
National Health Insurance Program(HR 676)

• www.SiCKOCure.org
• www.pnhp.org

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United States 46 Million Uninsured
But simply covering them with existing policies
is not a solution.
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Americas 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
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Medical Bankruptcy

• Illness and Medical Bills Contribute to HALF of
  all Bankruptcies.

Insurance Status at Onset of Illness

• Of those, more than three-quarters had insurance
  when they got sick.

Source Himmelstein, Health Affairs 2005 (state
estimates provided by author)
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Rising Costs Fewer Benefits Under/Uninsurance
Proportion of Americans Covered by Employer
Insurance
Source US Census
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What Does This Mean?
Lesson 1 Simply Expanding Existing Private
Insurance Policies Is Not a Solution.
Current Private Insurance Policies Offer
Inadequate Protection. Any Gains in Coverage
Will Be Quickly Offset as Costs Rise and
Employers Shed Benefits.
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What Does This Mean?
Lesson 2 Any Real Solution to the Health Crisis
Must Do Two Things
1) Offer Coverage More Comprehensive than that
Currently Available on the Private Market.
2) Control Costs so that Benefits are
Sustainable.
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Life Expectancy, 2003
(Data in Years)
Source Organization for Economic Cooperation and
Development (OECD)
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Infant Mortality, 2003
(Deaths in first year of life per 1,000 live
births)
Source Organization for Economic Cooperation and
Development (OECD)
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International Health Spending
U.S. Public Spending is Greater than Other
Nations
Public/Private Spending Combined
Per Capita Health Spending, 2004
Source OECD 2004 Japan and Germany data are
from 2003
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Insurance Companies Paperwork Waste

• Billing
• Marketing
• Underwriting
• Co-Payment Processing
• Eligibility Determinations
• Utilization Reviews
• Provider Administrative Staff
• Employer Benefit Administration

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Growth of Physicians and Administrators 1970-2005
Source Bureau of Labor Statistics and NCHS
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One-Third of Health Spending is Consumed by
Administration
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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
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Financing Single-Payer
Medicare
Single-Payer Health Care Fund
Medicaid
Payroll Tax
Income Tax
Bonus Negotiated formulary with physicians,
global budget for hospitals, increased primary
and preventive care, reduction in unnecessary
high-tech interventions, bulk purchasing of drugs
and medical supplies long term cost control.
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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 and hospital.
• Health Workers Unleashed from corporate dictates
  over patient care.
• Hospitals guaranteed a secure, regular budget.

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Only Two Paths to Reform

• Preserve Private Insurance Companies and their
  Waste
• Create a National Health Insurance System

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Save the Insurance CompaniesA Bipartisan
Consensus

• Private Insurance Tax Credits

National Health Program
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Subsidy and Individual Mandate Schemes(The
Edwards and Obama Plans)

• Substandard Coverage forces the uninsured to buy
  defective insurance industry products that are
  already causing families to face bankruptcy and
  go without needed care.
• Unaffordable Without the savings achievable with
  single-payer, taxes must raised or funds diverted
  from other needy programs.
• Micro-coverage, Macro-costs Preserves wasteful
  private insurers and adds yet another layer of
  state administrative waste. Rather than provide
  care to the 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.

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Sounds Great, but its not politically feasible

• 2/3rds of population want it
• Many (probably most) physicians want it
• Business community is now realizing the need for
  it

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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 wouldnt
  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 wouldnt be a company-wide financial
  crisis. You might even save money.
• -Joseph Antony, CNBC / MSN Money, Winter 2003

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A Step Towards Universal Coverageor The
Definition of Insanity?Other States That Have
Taken Steps
Uninsured 2005
Uninsured at Time

• Hawaii (1974) 82,000 116,000
• Massachusetts (1988) 494,000 617,000
• Oregon (1989) 400,000 578,000
• Tennessee (1992) 687,000 835,000
• Minnesota (1992) 350,000 430,000
• Maine (2003) 133,000 142,000

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Is The Perfect the Enemy of the Good?The
Radical and the Republican
Many of Lincolns 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
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Single-Payer Politically Feasible?
Other Politically Infeasible Movements

• Abolition of Human Slavery
• (1600s)
• Womens Suffrage Movement
• (1840-1920)
• Civil Rights Act
• (1964)

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What You Can Do

• Join Up with the campaign for HR 676 at
  www.sickocure.org. Use the resources on the site
  to educate yourself, your family and your friends
  about the single-payer solution.
• Sign the Citizens Petition for single-payer
  national health insurance (on the website).
• Contact your Members of Congress to tell them you
  support HR 676, and they should too.
• Write an Op-Ed or Letter to the Editor of your
  local paper. You can find tips, templates and
  examples at www.sickocure.org.
• Bring Materials and Talk to your church, labor,
  community or other group about the single-payer
  solution. The SickoCure website includes sample
  resolutions that your group can endorse and a
  copy of this slideshow you can use.