Title: KaoPing Chua Jack Rutledge Fellow, 20052006 American Medical Student Association
1Kao-Ping ChuaJack Rutledge Fellow,
2005-2006American Medical Student Association
The Case for Universal Healthcare
2What is Universal Health Care?
3What is Universal Health Care?
- No American should lack access to health care
- because he or she lacks the ability to pay for it
- when needed, and no American should suffer
- serious financial distress or personal bankruptcy
- as a result of unpaid medical bills.
- Uwe Reinhardt, Princeton health economist
4Countries with Universal Health Care
(South Africa)
Industrialized countries without universal health
care? only one
5Weighing the Arguments
Moral Economic
Moral Economic
6The moral argument for UHC
7The Central Moral Question
- Is it wrong to deny people healthcare based on
the ability to pay?
85 TIMES!
Source KFF/HRET Survey of Employer-Sponsored
Health Benefits 1999 2004
9How Many Uninsured?
45,000,000 Americans
10Annual deaths by cause, age 25-64
11The uninsured receive poor medical care
- Inability to fill prescription
- Lack of regular healthcare provider or
institution - Poor care of chronic disease
- The unhappy triad of uninsurance
- Receive less preventive care
- Diagnosed at more advanced disease stages
- Once diagnosed, receive less therapeutic care
12The economic argument for UHC
13The central economic question
- Will we save money by achieving universal health
care?
14A 3 part question
- How much would it cost to cover everyone?
- How much does it cost to NOT cover everyone?
- Do the costs of UHC outweigh the benefits?
15How much would it cost to cover everyone?
34-69 billion per year
16How much would it cost to cover everyone?
(Reinhardt, 2003)
- Assume 100 billion cost to government in the
first year of a UHC program - Assume increase of per capita health spending by
10/year - Total cost 1.6 trillion over 10 years,
- or about 160 billion per year
17Questions to ask
- How much would it cost to cover everyone?
- How much does it cost to NOT cover everyone?
- Do the costs of UHC outweigh the benefits?
18How much does it cost NOT to cover everyone?
- IOM 65-130 billion in lost productivity per
year
19How much does it cost NOT to cover everyone?
- Job lock (3.8 million jobs)
- Less preventive/chronic disease care ? costly
- High rate of medical bankruptcy
- Unnecessary use of the ER
20How much does it cost NOT to cover everyone?
- Costs of keeping current employer-based system
- Loss of global competitiveness
- Strain on businesses
21Questions to ask
- How much would it cost to cover everyone?
- How much does it cost to NOT cover everyone?
- Do the costs of UHC outweigh the benefits?
22Do the costs of UHC outweigh the benefits?
Lost productivity Loss of entrepreneurship Less
preventive care Unnecessary use of ER Less
global competitiveness Strain on business
160 billion per year
23- "The issue of universal coverage is not a
- matter of economics. Little more than 1 of
- GDP assigned to health could cover all.
- It is a matter of soul."
- - Uwe Reinhardt
24UHC and American values
- Do we believe in
- Getting good value for our money?
25US Spending on Health Care, 2002
Total health care costs comprise 14 of GDP!
1.7 trillion
Source OECD Health Data 2002, Health Affairs
2002 2188-99
26Best Health Care in the world? (WHO Rankings 2000)
1. France
31. Finland 32. Australia 33. Chile 34.
Denmark 35. Dominica 36. Costa Rica 37. United
States of America 38. Slovenia 39. Cuba 40.
Brunei Darussalam
2. Italy 3. San Marino 4. Andorra 5. Malta
6. Singapore 7. Spain 8. Oman 9. Austria 10. Japan
21. Belgium 22. Colombia 23. Sweden 24.
Cyprus 25. Germany 26. Saudi Arabia 27. United
Arab Emirates 28. Israel 29. Morocco 30. Canada
Source World Health Organization, Health
Systems Improving Performance, 2000
27Infant Mortality, 2000Deaths/100,000 Births
Source OECD, 2003
28Life Expectancy, 2000
Source OECD Health Data 2003
29The 3 Big Questions
- Is it wrong to deny people healthcare
- based on the ability to pay?
- Will we save money by
- achieving universal health care?
- Is universal health care consistent with
- American values?
30Benefits for providers
- UHC will
- Allow you to more successfully treat patients
- Allow you to be your patients doctor, not their
financial counselor/social worker. - Allow you to base your decisions on medical care
on best practices, not on your patients ability
to pay
31Parting thoughts
The Americans will always do the right
thingafter theyve exhausted all the
alternatives. - Winston Churchill