Title: Health care is an essential safeguard of human life and dignity, and there is an obligation for society to ensure that every person be able to realize this right.
1- "Health care is an essential safeguard of human
life and dignity, and there is an obligation for
society to ensure that every person be able to
realize this right." - Cardinal Joseph Bernardin
2Universal Health Care An American Dream or
Reality?
3Goals for Presentation
- CONSEQUENCES OF BEING UNINSURED
- US VS OTHER DEVELOPED COUNTRIES
- WHERES THE WASTE?
- WHAT IS SINGLE PAYER?
4- CONSEQUENCES OF BEING UNINSURED
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6Who Are The Uninsured?
718,314 Adult Deaths Annually Due to Uninsurance
8Unmet Health Needs of the Uninsured
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11- US vs. OTHER DEVELOPED COUNTRIES
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15The next several slides show data from the
recently-released US./Canada Health Survey - a
bi-national study carried out jointly by the two
nations health statistics agencies. The point
here, is that the average Canadian gets care very
similar to that received by insured Americans.
On average (with the uninsured included),
Canadians receive better care than Americans,
despite spending far less.
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17The U.S. continues to trail most other developed
nations in key health indicators, despite
spending far more on care.
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19Despite spending far more on health care than any
other nation, Americans do not get large amounts
of care.
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24Number of Nurses per 1000 Population
25Percent of Population withGovernment-Assured
Insurance
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27 28US Drug Spending
29Drug Company Profits
30While drug firms have trumpeted their research
innovations, they have developed few important
new drugs in recent years. Indeed, drug stocks
have slumped recently because investors fear that
the pipeline of new drugs is largely empty.
Among important new drugs that have been
introduced in recent years, most were the
products of either NIH-funded research, or were
discovered at small firms and sold to the major
drug firms at a late stage in their development.
It appears that the evolving model of commercial
domination of science, with many scientists and
research universities scrambling to cut deals
with drug firms, may be leading down a
scientific dead end.
31Government Funds Most Academic Research
32Drug Companies Cost Structure
33Administrative Cost
- 375 Billion per year
- 1 million Americans pushing paper rather than
delivering direct health services - Private health insurers and HMOs consume 13.6
percent of premiums for overhead, while both the
Medicare program and Canadian NHI have overhead
costs below 3 percent
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35Private insurers High Overhead
36Insurance Overhead 2001
37Who Pays for Health Care? Regressivity of US
Health Financing
38Is there any mystery why many Blue Cross
executives are anxious to turn for-profit and
join Anthem (a former Blue Cross plan).
39Health Costs as of GDP US Canada
40 41The Healthcare Americans Get
- 1/3 are uninsured or underinsured
- HMOs deny care to millions more with expensive
illnesses - Death rates higher than other wealthy nations
- Costs double Canada's, Germany's, or Sweden's -
and rising faster - Executives and investors making billions
- Destruction of the doctor/patient relationship
42The Healthcare Americans Want
- Guaranteed access
- Free choice of doctor
- High quality
- Affordability
- Trust and respect
43The 4 principles of single payer
- Access to comprehensive health care is a human
right. - The right to choose and change one's physician is
fundamental to patient autonomy. - Pursuit of corporate profit and personal fortune
have no place in caregiving and they create
enormous waste. - In a democracy, the public should set overall
health policies.
44Single public plan would cover every American for
all medically-necessary services
- acute, rehabilitative, long term and home care,
mental health, dental services, occupational
health care, prescription drugs and supplies, and
preventive and public health measures
45Private insurance would be proscribed because
- Private insurers would continually lobby for
underfunding of the public system - If the wealthy could turn to private coverage,
their support for adequate funding of NHI would
also wane - Private coverage would encourage doctors and
hospitals to provide two classes of care - A fractured payment system would subvert quality
improvement efforts, e.g. the monitoring of
surgical death rates and other patterns of care - Eliminating multiple payers is essential to cost
containment
46Payment for Hospital Services
- NHI would pay each hospital a monthly lump sum to
cover all operating expenses - that is, a global
budget. - Global budgeting would simplify hospital
administration and virtually eliminate billing,
freeing up substantial resources for enhanced
clinical care
47Payment for Physicians and Outpatient Care 3
Options
- fee-for-service
- salaried positions in institutions receiving
global budgets - salaried positions within group practices or HMOs
receiving capitation payments
48Capital Allocation, Health Planning, and Profit
- Funds for the construction or renovation of
health facilities, and for major equipment
purchases would be appropriated from the NHI
budget. - Regional health planning boards of both experts
and community representatives would allocate
these capital funds.
49Prescription Drugs and Supplies
- NHI would pay for all medically necessary
prescription drugs and medical supplies, based on
a national formulary - An expert panel would establish and regularly
update the formulary - NHI would provide all Americans with full
coverage for necessary drugs and supplies - NHI would contain drug costs as a monopsony
purchaser, by exerting substantial pressure on
pharmaceutical companies to lower prices
50Funding for NHI
- Disburse virtually all payments for health
services - Total expenditures would be set at approximately
the same proportion of the Gross National Product
as in the year preceding the establishment of NHI
- Funding would be based on an income or other
progressive tax because this is fairest and most
efficient solution
51How Do We Know It Can Be Done?
- Every other industrialized nation has a
healthcare system that assures medical care for
all - All spend less than we do most spend less than
half - Most have lower death rates, more accountability,
and higher satisfaction - Not a single one has gone to that system, found
it to be worse, and switched back - NONE
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53We Have What it Takes
- Excellent hospitals
- Enough well-trained professionals
- Superb research
- Current spending is sufficient