Health Care Reform Quynh Smith

Sources of Inefficiency in the Health Care Delivery System   We spend a substantial amount on high cost, low-value treatments.   Patients obtain too little of certain types of care that are effective.   Patients frequently do not receive care in the most cost- effective.   There is extensive variation in the quality of care provided to patients.   There are many preventable medical errors that lead to worse outcomes.   Our system is complex and we have high administrative costs.

What is Health Care Reform?  Broaden the population that receives health care coverage through either public sector insurance programs or private sector insurance companies  Expand the array of health care providers consumers may choose among  Improve the access to health care specialists  Improve the quality of health care  Decrease the cost of health care

Trends in Health Care Spending and Cost

Overall Spending   Based on Organization of for Economic Co- Operation and Development (OECD):   The U.S. devotes considerably more of its economy to health care than other developed countries.   U.S. health spending as a share of GDP in 2006 (15.3%) was considerably higher than all other countries, including Canada (10.0%), France (11.0%), Germany(10.6%), Japan (8.1%), and the United Kingdom (8.4%).   Switzerland was a distant second to the U.S., devoting an estimated 11.3% of GDP to health care.

Overall Spending   According to the Centers for Medicare and Medicaid Services (CMS), the U.S. is projected to spend over $2.5 trillion on health care in 2010, or $8,160 per U.S. resident.   Health spending in 2009 is projected to account for 17.6% of GDP.   In 1970, U.S. health care spending was about $75 billion, or $356 per resident, and accounted for 7.2% of GDP.   Health care spending has risen about 2.4 percentage points faster than GDP since   CMS projects that by 2018, health care spending will be over $4.3 trillion, or $13,100 per resident, and account for 20.3% of GDP.

Distribution by Service

Sources of Health Spending  Between private and public sectors, private health spending accounts for 54% of total health spending in  64% expenditures from private health insurance  22% expenditures from out-of-pockets  13% by other private sources (philanthropy)

Sources of Health Spending   CMS projects that the private share of national health spending will fall to 49% by 2018, with public spending growing to 51% as the oldest baby boomers become eligible for Medicare.

Rises in Premiums of Health Insurance  Between , the cumulative growth in insurance premiums was 119%.  Compared with cumulative inflation of 29 % and cumulative wage growth of 34%.

Uninsured in America

Percent of Americans Uninsured by Age

Who Are the Uninsured?   More than eight in ten of the uninsured are in working families—about two thirds are from families with one or more full-time workers and 14% are from families with part-time workers.   About two-thirds of the uninsured are poor or near poor.   Adults are more likely to be uninsured than children.   The number of nonelderly uninsured Americans rose to 45.7 million in 2008 amidst rising unemployment rates and an economic recession.

2009 Federal Poverty Line

American Recovery and Reinvestment Act 2009 Provided over $2 billion to expand the number of sites, increase services at existing CHCs, and provide supplemental payments for spikes in the number of uninsured CHCs serve as a result of the recession.

Texas vs. United States

President Obama’s Proposal

President Obama’s Health Plan  Reduce long-term growth of health care costs for businesses and government  Protect families from bankruptcy or debt because of health care costs  Guarantee choice of doctors and health plans  Invest in prevention and wellness  Improve patient safety and quality of care  Assure affordable, quality health coverage for all Americans  Maintain coverage when you change or lose your job  End barriers to coverage for people with pre-existing medical conditions

Public Opinion on Health Reform

Health Care Proposals Senate Democratic Bill (Patient Protection Affordable Care Act) And House Bill (Affordable Health Care for America Act)

The House and Senate versions:  Insurance reforms to protect consumers from insurance company worst-practices – like denying coverage based on pre-existing conditions, capping total coverage, and dropping or watering down coverage when you get sick and need it most  Consumer protections that will restrict how much of your premium dollars insurance companies can spend on marketing, profits, salaries.  Creation of a health exchange to increase consumer choice and guarantee coverage  A commitment to expanding health coverage  Affordable health options, with subsidies for working families and a hardship waiver  Tax credits to help small businesses afford coverage

The House and Senate versions:  Improvements in the health status of our population by investing in prevention and chronic disease management  Making preventive care completely free – with no copayments or deductibles  Lowering the cost of health care for our seniors  Improving the quality and extending the life of Medicare  Strengthening our primary care workforce  Reforming the delivery system  Ensuring that reform is not only fully paid for, but actually significantly reduces the federal deficit

Health Reform Subsidy Calculator

Senate Democratic Bill Note: Subsidies are only available for people purchasing coverage on their own in the Exchange (not through an employer). All individuals and families with incomes at or below 133% of the federal poverty level will be eligible for Medicaid. Others with higher incomes may also be eligible, depending on rules that vary by state.

Senate Democratic Bill Note: Subsidies are only available for people purchasing coverage on their own in the Exchange (not through an employer). All individuals and families with incomes at or below 133% of the federal poverty level will be eligible for Medicaid. Others with higher incomes may also be eligible, depending on rules that vary by state.

House Bill Note: Subsidies are only available for people purchasing coverage on their own in the Exchange (not through an employer). All individuals and families with incomes at or below 150% of the federal poverty level will be eligible for Medicaid. Others with higher incomes may also be eligible, depending on rules that vary by state.

House Bill Note: Subsidies are only available for people purchasing coverage on their own in the Exchange (not through an employer). All individuals and families with incomes at or below 150% of the federal poverty level will be eligible for Medicaid. Others with higher incomes may also be eligible, depending on rules that vary by state.

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