1. Physicians for a National Health Program 29 E Madison Suite 602, Chicago, IL 60602 Phone (312) 782-6006 | Fax: (312) 782-6007 email: info@pnhp.orginfo@pnhp.org www.pnhp.org Single Payer Universal Health Care: The Only Solution Diljeet K. Singh, MD, DrPH

2. David Apsey, DDS drdavid2450@yahoo.com Al G knows how to reach me if any questions arise.

3. Moral, Socially Responsible Vision of Society Health care is… A Human Right A social service distributed according to need Not a commodity distributed according to ability to pay Not a business whose “beneficiaries” are company executives and investors not patients Most Americans believe everyone should have access to good care without financial hardship

4. 47 Million Uninsured 45,000 Deaths Per Year But simply helping them buy private insurance is not a solution.

5. Life Expectancy, 2005 (Data in Years)

6. Infant Mortality, 2005 (Deaths in first year of life per 10,000 live births)

8. Medical Bankruptcy Illness & Medical Bills Contributed to 1,000,000 Personal Bankruptcies in 2004. (Half of All Bankruptcies) Source: Himmelstein, Health Affairs 2005 (state estimates provided by author) Insurance Status at Onset of Illness Had Insurance Uninsured

9. Who Are the Uninsured? »Employed »50% »Children »25% »Unemployed »5% »*Out of labor force »20%

10. America’s Underinsured Proportion of Americans Going Without Care due to Costs, 2005 (skipping doctor visit, specialist appointment, treatment or prescription when needed) Source: Commonwealth Fund Biennial Health Insurance Survey, 2005

11. PERSPECTIVE- Practical Current system is unsustainable Private health insurance premiums are  at unsustainable rate of 13-25%/year Coverage is shrinking, as employers cap their contributions to health insurance & workers are unable to pay their rapidly growing share Most expensive health care system in the world

12. Rising Costs = Less Benefits = Under/Uninsurance Proportion of Americans Covered by Employer Insurance Source: US Census

13. Problem with For-Profit Payers Investor-owned firms profit by avoiding unprofitable patients & limiting services The administrative, marketing and profits divert resources from clinical care. Doctors & hospitals maintain costly admin staff to deal with bureaucracy Adminstration consumes 31% of our health care $

14. Growth of Physicians & Administrators 1970-2005 Source: Bureau of Labor Statistics & NCHS

15. Source:Agency for Healthcare Research & Quality MEPS Percent of health Care Costs 1% 1% 2% 4% 6% 13% 73% 0% 0% 0% The Health & Profitable to the “Market,” the Sick & Poor to the Taxpayer Private Insurers Government Programs 80% uses less than $1000 of care per year

16. Costs to Business Health care cost General Motors $5.6 billion in 2005 adding $1500 to the price of each car Companies that offer coverage often pay 10% or more of payroll on health benefits and are at a disadvantage competing with companies that don’t offer coverage or where there is public coverage Toyota located a new plant in Canada and Lifesavers moved a Michigan factory to Ontario Skyrocketing costs for health care are hurting U.S. business:

17. GM retiree cost is $60 Billion! Source: Wall St. Journal, March 11, 2004

18. “Individual Mandate” “Let them buy insurance.”

19. Criminalizing the Uninsured: A Massachusetts Punitive Index #The CrimeThe Fine 1 Violation of Child Labor Laws $50 2 Illegal Sale of Firearms, First Offense $500 max. 3 Driving Under the Influence, First Offense $500 min. 4 Domestic Assault $1000 max. 5 Cruelty to or Malicious Killing of Animals $1000 max. 6 Communication of a Terrorist Threat $1000 min. 7 Being Uninsured* $1500 min. *Note: Original version of House Bill would have suspended individuals’ driving licenses for uninsurance as well.

20. Subsidy & Individual Mandate Schemes Substandard Coverage: forces uninsured to buy defective policies that cause bankruptcy & going without needed care. Unaffordable: With insurance subsidies, taxes must be raised or funds diverted from other needy programs. (Single-payer is revenue neutral) Rather than provide care to uninsured through an efficient program like Medicare, the plan launders tax dollars through wasteful private insurers. No Realistic Cost Control: Any gains in public coverage will be unsustainable due to rising costs.

21. International Health Spending, 2005 U.S. Public Spending is Greater than Other Nations’ Public/Private Spending Combined Source: OECD 2007; Japan data are from 2004

22. Other Industrialized Nations Have similar demographics Availability of expensive technology Rising drug costs Similar levels of service Why are their costs so much lower?

23. Solution - Single-Payer – HR676 Simpler & more efficient than our private health care system with $ distributed by one entity for all necessary health care This Means extending Medicare to entire population Government-financed single-payer system with private, market-based system of doctors. Medicare is the most efficient part of our health- care system, with overhead costs of < 3% Covers virtually everyone over 65 Most popular part of U S health care system

24. Single-Payer – HR676 Universal, Comprehensive Coverage including Dental and Vision with: No out-of-pocket payments Co-payments & deductibles are barriers to access and ineffective for cost containment Single insurance plan in each region, administered by public agency Global operating budgets for hospitals, nursing homes A capital improvement budget separate from operating expenses will be allowed

25. Key Features of Single-Payer Free Choice of Providers Patients will be free to seek care from any licensed health care provider, without financial incentives or penalties Public Accountability, Not Corporate Dictates The public will set overall health policies & priorities, medical decisions will be made by patients & providers in the region. Ban on For-Profit Health Care Providers For - Profit hospitals divert resources from patients to investors Protection of health care & insurance workers

26. The Healthcare Americans Want Guaranteed access Free choice of doctor High quality Affordability Trust & respect

27. Only Two Paths to Reform 1.Preserve Private Insurance Companies & their Waste 2.Create a National Health Insurance System

28. Single-Payer Benefits Comprehensive Coverage for all medically necessary services in a single-tier system. Free Choice of doctor & hospital. Health Workers Unleashed from corporate dictates over patient care. Hospitals guaranteed a secure, regular budget.

29. Medicare Medicaid Payroll Tax Income Tax Single-Payer Health Care Fund $$$ Financing Single-Payer Bonus: Negotiated formulary with physicians, global budget for hospitals,  primary & preventive care, bulk purchasing of drugs & medical supplies = long term cost control.

30. “Sounds Great, but it’s not politically feasible” 2/3rds of population want it Most (59 percent) of physicians want it Business community is now realizing the need for it.

31. Single-Payer: Glen Barton Former CEO, Caterpillar Inc. (Fortune 100) Past Chairman, Health & Retirement Task Force Business Roundtable Represents 150 Largest Employers Total Assets: $4.0 Trillion “The quickest & simplest solution… is to go to a single-payer system” - Written Testimony to AHCTF, Feb. 1 2006

33. Is “The Perfect the Enemy of the Good?” The Radical & the Republican “Many of Lincoln’s admirers have painted him as a man who wanted exactly what the abolitionists did but cannily waited for a perfect moment to achieve it. [In fact], radicals like Douglass set an agenda Lincoln gradually adopted as his own. Without abolitionists, there would have been no Lincoln.” - James Oakes, Historian, UC Berkeley

34. Single-Payer: “ Politically Feasible? ” Abolition of Human Slavery (1860s) Women’s Suffrage Movement (1840-1920) Civil Rights Act (1964) Other “Politically Infeasible” Movements