What Is Driving Health Care Reform? Within five decades…US GDP devoted to health care costs increased from 5.5% to 16%. Congressional budget office projected…that the figure could reach 25% by U.S. spends more than $ 2 trillion on health care every year. It is claimed that despite spending billions more than any industrialized country, U. S. health care outcomes are no better and in many cases worse than other countries. Rising insurance premiums, co-pays and deductibles High number of uninsured and underinsured Recession

Other Reasons to Consider Patient demands and expectations Defensive medicine Heart Disease/cancer/stroke/chronic lung disease/diabetes epidemic/overweight -75% of health care dollars Aging population

Rep. Conyers (D-MI) has introduced House Bill H.R. 676 Bill Title: To Provide a Comprehensive Health Insurance Coverage for All United States Residents, Improved Health Care Delivery, and for other purposes

1.Provide anyone residing in U.S. with free health care that includes all medically necessary care, such as primary care and prevention, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care 2.Gives patients the freedom to choose from participating physicians and institutions 3.Prohibits a private health insurer from selling health insurance coverage that duplicates the benefits provided under this Act 4.Establishes a National Board of Universal Quality and Access to provide advice on quality, access, and affordability Key Point of Conyers Bill

1.Members of Board (appointed by President of U.S.) will include: Health care professionals Reps of health care institutions Reps of health advocacy groups Citizen patient advocates Reps of labor unions 2. Board shall establish a universal standard of care with respect to- salary level and working conditions of physicians, clinicians, nurses, other medical professionals, and appropriate support staff Key Points About Conyers National Board of Universal Quality and Access

1.Health Exchange 2.Public Insurance Option 3.Responsibility of individuals to have insurance 4.Responsibility of employers to provide employee insurance or pay a fee or tariff if they do not comply 5. Universal health coverage for all Americans *PREPARED BY THE HOUSE COMMITTEES ON WAYS AND MEANS, ENERGY AND COMMERCE, AND EDUCATION AND LABOR JUNE 19, 2009

H.R.3200 Title: To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Sponsor: Rep Dingell, John D. [MI-15] (introduced 7/14/2009) Cosponsors (8)Rep Dingell, John D.Cosponsors

Senate Finance Committee Chairman Max Baucus (D-MT) authored a white paper titled: Call to Action Health Care Reform 2009 U.S. Senator Max Baucus, "Call to Action: Health Care Reform 2009," November 12, 2008, at (November 14, 2008).

CALL TO ACTION HEALTH REFORM 2009 CALL TO ACTION HEALTH REFORM 2009 November 12, 2008 U.S. Senator Max Baucus (D-Mont.) Chairman, Senate Finance Committee

Description of Policy Options Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans Senate Finance Committee May 14, 2009

Description of Policy Options Financing Comprehensive Health Care Reform: Proposed Health System Savings and Revenue Options Senate Finance Committee May 20, 2009

Baucus Proposals Universal health coverage (306, 555, 867 U.S. population May, 2009) (306, 923,343U.S population July, 5, 2009) Mandatory Health Insurance Individual- play or pay Employers- play or pay Public insurance plan funded by taxes..to ensure that the public-private insurance competition lowers costs …* Health Insurance Exchange (nationwide insurance pool) Independent Health Coverage Council (supervising and controlling body) *Call To Action Health Care Reform 2009, Senator Baucus, Nov. 12, 2008 p. 18

Funding a Public Health Plan The total cost of public health plan: $1 Trillion to $1.5 Trillion over 10 years Runs counter to proposed health care saving of $309 billion Suggestions to raise this revenue to pay for expansive program Reducing paperwork (electronic records) Bulk procurement of medications Access to preventative care Taxes on health care benefits Higher sin taxes (taxes on alcohol, sweetened beverages) Higher federal income tax? Higher payroll taxes (Medicare Tax)? Cap deductions on charitable contributions and mortgage interest Medicare Advantage payments equal to traditional Medicare Decrease Medicare and Medicaid spending Print more money!

H.R Americas Affordable Health Choices Choices Act of 2009 by Rep. Dingell D Michigan House Ways and Means Committee CBO Douglas W. Elmendorf, Director, July 17, 2009 Collectively, those provisions would yield a significant increase in the number of Americans with health insurance. By 2019, CBO and the staff of JCT estimate, the number of nonelderly people without health insurance would be reduced by about 37 million, leaving about 17 million nonelderly residents uninsured (nearly half of whom would be unauthorized immigrants). In total, CBO estimates that enacting those provisions would raise deficits by $1,042 billion over the period. According to CBOs and JCTs assessment, enacting H.R would result in a net increase in the federal budget deficit of $239 billion over the period.

CBO: Health bills would be more costly By David M. Dickson (Contact)David M. DicksonContact Originally published 04:15 p.m., July 16, 2009, updated 04:26 p.m., July 16, 2009 Washington Times The Democratic health-reform bills making their way through Congress this week would worsen the nation's long-term fiscal problems, the director of the nonpartisan Congressional Budget Office told the Senate Budget Committee Thursday. Rep. Clyburn said House Democrats are prepared to push forward with a bill before the August recess no matter what CBO says in its formal scoring. Congressional Quarterly July 20, 2009

MASSACHUSETTS IN SUIT OVER COST OF UNIVERSAL CARE By ABBY GOODNOUGH A hospital says the state has siphoned off money to help pay the considerable cost of insuring all but a small percentage of residents. July 16, 2009 MASSACHUSETTS TAKES A STEP BACK FROM HEALTH CARE FOR ALL By ABBY GOODNOUGH The new state budget in Massachusetts eliminated health care coverage for some 30,000 legal immigrants to help close a growing deficit. July 15, 2009 Governors Fear Medicaid Costs in Health Plan New York Times By KEVIN SACK and ROBERT PEARKEVIN SACKROBERT PEAR Published: July 19, 2009

Cause for Concern Government will have to ration care Access to medications will be limited Source: Government Run Health Care: A World of Hurt by Robert Moffit and James Frogue. Healthcare institutions (hospitals, health insurance companies) and health care providers will lose billions Substantially lower payments to physicians Less incentive for talented people to choose careers in health care Limited ability of physicians to invest in new medical technology Source: Single Payer: Why Government - Run Health Care Will Harm Both Patients and Doctors Robert Book

Cause for Concern No meaningful tort reform in these bills/proposals that would protect us from litigation if healthcare services are denied by a government agency and an adverse outcome occurs with litigation forthcoming.

Health Care Reform 2009 Blue Print for Socialized Health Care in America 2009 Reconciliation: The passage of legislation without due debate and amendment introduction by other party

What You Can Do 1. Keep informed about health care legislation (congress.gov), Congressional Quarterly, The Hill, Heritage Foundation. 2. Call your local Senators and Representatives. Talking points-if you favor a public health insurance plan: Will you promise not to raise my income tax to support it? Can you guarantee that it will lower health care costs? Will you be rationing my health care? How will you prevent waste in this public plan? Will you use reconciliation to pass this public plan and not allow debate regarding my health care? 3. Tell your patients, families, and friends about the possible impending changes in their health care that may occur. Provide them with information and encourage them to call their representatives with their concerns. 4. Invite your representatives for a town hall meeting to present their views and plans on health care reform. Request a group meeting in Washington, D.C. with your representative.

Senator Bob Casey casey.senate.gov/contact Washington D.C. 383 Russell Senate Office Building Washington, D.C Phone: (202) Toll Free: (866) Fax: (202) Pittsburgh Pittsburgh Regional Enterprise Tower 425 Sixth Avenue, Suite 2490 Pittsburgh, PA Phone:20(412) Fax: (412) Senator Arlen Specter specter.senate.gov/ contact Washington DC 711 Hart Building Washington, DC Main: Fax: Pittsburgh 425 Sixth Avenue, Suite 1450 Regional Enterprise Tower (old Alcoa Building) Pittsburgh, PA Main: Fax: