Presentation on theme: ""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."— Presentation transcript:
"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
Universal Health Care: An American Dream or Reality?
Goals for Presentation CONSEQUENCES OF BEING UNINSURED US VS OTHER DEVELOPED COUNTRIES WHERE’S THE WASTE? WHAT IS SINGLE PAYER?
CONSEQUENCES OF BEING UNINSURED
Who Are The Uninsured?
18,314 Adult Deaths Annually Due to Uninsurance
Unmet Health Needs of the Uninsured
US vs. OTHER DEVELOPED COUNTRIES
The 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.
The U.S. continues to trail most other developed nations in key health indicators, despite spending far more on care.
Despite spending far more on health care than any other nation, Americans do not get large amounts of care.
Number of Nurses per 1000 Population
Percent of Population with Government-Assured Insurance
WHERE’S THE WASTE?
US Drug Spending
Drug Company Profits
While 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.
Government Funds Most Academic Research
Drug Companies’ Cost Structure
Administrative 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
Private insurers’ High Overhead
Insurance Overhead 2001
Who Pays for Health Care? Regressivity of US Health Financing
Is there any mystery why many Blue Cross executives are anxious to turn for-profit and join Anthem (a former Blue Cross plan).
Health Costs as % of GDP: US & Canada
WHAT IS SINGLE PAYER?
The 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
The Healthcare Americans Want Guaranteed access Free choice of doctor High quality Affordability Trust and respect
The 4 principles of single payer: 1.Access to comprehensive health care is a human right. 2.The right to choose and change one's physician is fundamental to patient autonomy. 3.Pursuit of corporate profit and personal fortune have no place in caregiving and they create enormous waste. 4.In a democracy, the public should set overall health policies.
Single 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
Private 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
Payment 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
Payment for Physicians and Outpatient Care: 3 Options 1.fee-for-service 2.salaried positions in institutions receiving global budgets 3.salaried positions within group practices or HMOs receiving capitation payments
Capital 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.
Prescription 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
Funding 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
How 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
We Have What it Takes Excellent hospitals Enough well-trained professionals Superb research Current spending is sufficient