Health Care for All in Michigan

1. Health Care for Allin Michigan Prepared by Michigan Legal Services; Michigan Universal Health Care Access Network; and MOSES. August 2007 Health Insurance for All is an idea whose time has come. This program shows the problems caused by our present health care finance and delivery systems, why we need major reform, and some ideas on how to make those changes. We do not take a position on what sort of system to implement.Health Insurance for All is an idea whose time has come. This program shows the problems caused by our present health care finance and delivery systems, why we need major reform, and some ideas on how to make those changes. We do not take a position on what sort of system to implement.

2. Our vision for a health care solution in Michigan--imagine a system where �. Imagine universal access.Imagine universal access.

3. You can change jobs and pursue your career without worrying if your benefits will still be there; People now make career plans around health care coverage � staying in jobs that they don�t like in order to keep coverage, and if they don�t have health care looking for jobs that provide health care. Entrepreneurs starting small businesses are put at a disadvantage because of health care costs. People now make career plans around health care coverage � staying in jobs that they don�t like in order to keep coverage, and if they don�t have health care looking for jobs that provide health care. Entrepreneurs starting small businesses are put at a disadvantage because of health care costs.

4. You don�t have to worry about a pre-existing condition blocking insurance coverage; Does anything sum up the insane cruelty of our health care system better than this?Does anything sum up the insane cruelty of our health care system better than this?

5. You can depend on your benefits to be there, even after you retire; While we may think we�re secure and have a good health plan, most of us are a divorce, job loss, or major illness away from being uninsured. Many people who thought they were secure for the rest of their lives (like auto workers) are now finding out that their benefits are being cut or eliminated. While we may think we�re secure and have a good health plan, most of us are a divorce, job loss, or major illness away from being uninsured. Many people who thought they were secure for the rest of their lives (like auto workers) are now finding out that their benefits are being cut or eliminated.

6. You can choose your own doctor and health facilities, without needing to worry if they�re �in your plan�; Your employer changes insurance plans, your physician gets dropped from the �panel� and you have to switch doctors, hospitals and other service providers Your employer changes insurance plans, your physician gets dropped from the �panel� and you have to switch doctors, hospitals and other service providers

7. You and your loved ones can depend on getting the health care you need, when you need it! The system we have right now is not sustainable. Even if you have coverage now, you are in great danger of losing it.The system we have right now is not sustainable. Even if you have coverage now, you are in great danger of losing it.

8. Costs are contained in an efficient system that helps boost the Michigan economy. Michigan�s economy has been significantly damaged by increasing health care costs and the impact on employers. Imagine a Michigan where companies want to do business because the work force is healthy, costs are contained and the responsibility for providing coverage is shared.Michigan�s economy has been significantly damaged by increasing health care costs and the impact on employers. Imagine a Michigan where companies want to do business because the work force is healthy, costs are contained and the responsibility for providing coverage is shared.

9. The System We Have Now �. Note: have clouds or sunshine or something lending itself to imagination and possibility.Note: have clouds or sunshine or something lending itself to imagination and possibility.

10. �Of all forms of Inequality, injustice in health care is the most shocking and inhumane.� Martin Luther King Jr. There is all kinds of inequality�income, educational opportunity, treatment by the police. But inequality that condemns some people to debility and premature death for lack of insurance coverage is inhumane.There is all kinds of inequality�income, educational opportunity, treatment by the police. But inequality that condemns some people to debility and premature death for lack of insurance coverage is inhumane.

11. The Highest Cost System We spend more per-capital than any other nation. We spend plenty. The problem is not spending! We spend 2x as much per person as many other countries yet 47,000,000 of us have no health insurance. How do they do it and why can�t we? We spend more per-capital than any other nation. We spend plenty. The problem is not spending! We spend 2x as much per person as many other countries yet 47,000,000 of us have no health insurance. How do they do it and why can�t we?

12. Health care spending in Michigan is $57 billion to $63 billion - $5700 to $6300 per person. Gov�s Council of Economic Advisors Again, we spend plenty. Our per person spending in Michigan is enough to cover everyone yet 1.1 million of us have no insurance. Again, we spend plenty. Our per person spending in Michigan is enough to cover everyone yet 1.1 million of us have no insurance.

13. Premium costs have risen five times faster than inflation and four times faster than wages This chart shows that the cost of health care premiums increases much faster than increases in wages and inflation. The costs continue to rise, while the number of uninsured grows and the economy suffers. A temporary dip occurred in 1996 after the Clinton administration proposed a plan for universal coverage, and health management organizations first came onto the market. This chart shows that the cost of health care premiums increases much faster than increases in wages and inflation. The costs continue to rise, while the number of uninsured grows and the economy suffers. A temporary dip occurred in 1996 after the Clinton administration proposed a plan for universal coverage, and health management organizations first came onto the market.

14. The average family premium of over $12,000 almost equals the gross annual earnings of fulltime minimum wage workers. Insurance is unaffordable for many people. Even when people have insurance it is often inadequate � for example, it may not cover hospital costs, mental health care or medications, and have high deductibles and co-pays. Insurance is unaffordable for many people. Even when people have insurance it is often inadequate � for example, it may not cover hospital costs, mental health care or medications, and have high deductibles and co-pays.

15. This is the most disturbing slide, for two reasons. Each year we spend more per-person, and yet each year, more people are uninsured. The curve is unsustainable�at this rate health care spending will soon exceed the gross domestic product. Without reform even those of us with coverage won�t be able to keep up with the increases. Inaction is not an option.This is the most disturbing slide, for two reasons. Each year we spend more per-person, and yet each year, more people are uninsured. The curve is unsustainable�at this rate health care spending will soon exceed the gross domestic product. Without reform even those of us with coverage won�t be able to keep up with the increases. Inaction is not an option.

16. The World Health Organization rates the American Health System as 37th in the world in health care performance. See Health Care 101 and WHO report dated 2000. Below Costa Rica, Chile, Columbia, Dominica� See Health Care 101 and WHO report dated 2000. Even though we spend far more per-capita than any other nation on earth, our health care ranks below that offered by many third world nations.Even though we spend far more per-capita than any other nation on earth, our health care ranks below that offered by many third world nations.

17. Our Economy SuffersGoodyear study at www.Goodyearnegotiations.com; 2005 data We lose good paying jobs to other countries because they see health care as a �shared responsibility� of their society. GM spends more on healthcare than on steel. Starbucks spends more on healthcare than on coffee. The figures for Toyota and Honda reflect their costs for cars built in Japan. Their costs in the US are much higher, but still lower than GM, Ford, and Chrysler because they have few retirees.GM spends more on healthcare than on steel. Starbucks spends more on healthcare than on coffee. The figures for Toyota and Honda reflect their costs for cars built in Japan. Their costs in the US are much higher, but still lower than GM, Ford, and Chrysler because they have few retirees.

18. More than half of U.S. bankruptcies are related to medical bills. [Health Affairs, Feb. 2, 2005] The high cost of health care leaves many of us a major illness or injury away from bankruptcy The high cost of health care leaves many of us a major illness or injury away from bankruptcy

19. The consequences. The consequences of runaway costs.The consequences of runaway costs.

20. Rising Health Care Costs Mean: Fewer people can pay for adequate coverage Fewer employers can pay for their employees The number of uninsured and underinsured continues to grow. The number of uninsured and underinsured continues to grow.

21. The majority � 80 % - of the uninsured in Michigan are employed people and their dependents. -US Census Many jobs no longer provide health insurance and the number of jobs that do continues to decline. Many jobs no longer provide health insurance and the number of jobs that do continues to decline.

22. Lack of access to care "I mean, people have access to health care in America. After all, you just go to an emergency room.� President George W. Bush 7/11/2007 People without insurance do not get routine and preventative medical care. Eventually they wind up in the emergency room. This is an extremely expensive way to practice medicine. This is why nations with universal access to care spend much less per-capita than the US. Universal Coverage is key to controlling costs. Some estimates: The US spends $100 billion yearly to provide the uninsured with medical care. The uninsured are 30% - 50% more likely to be hospitalized for avoidable conditions, at a cost of $3,300 per stay.People without insurance do not get routine and preventative medical care. Eventually they wind up in the emergency room. This is an extremely expensive way to practice medicine. This is why nations with universal access to care spend much less per-capita than the US. Universal Coverage is key to controlling costs. Some estimates: The US spends $100 billion yearly to provide the uninsured with medical care. The uninsured are 30% - 50% more likely to be hospitalized for avoidable conditions, at a cost of $3,300 per stay.

23. Lack of access to care Most health care dollars are spent on a relatively small number of people with chronic conditions. When uninsured people with these conditions are locked out of access to routine and preventative care they will eventually wind up in hospital emergency rooms suffering from acute crises. For example: When diabetes is not treated it can lead to amputations, blindness, and kidney failure. When coronary artery disease is not treated it leads to heart attack and stroke. When asthma is not treated it can lead to debilitating asthma attacks.Most health care dollars are spent on a relatively small number of people with chronic conditions. When uninsured people with these conditions are locked out of access to routine and preventative care they will eventually wind up in hospital emergency rooms suffering from acute crises. For example: When diabetes is not treated it can lead to amputations, blindness, and kidney failure. When coronary artery disease is not treated it leads to heart attack and stroke. When asthma is not treated it can lead to debilitating asthma attacks.

24. In the U.S. 50 people will die today 18,000 this year of treatable diseases because they do not have health insurance. Health Care 101, GMC; Institute of Medicine report (2004) Thousands of Americans are dying prematurely because they lack access to routine, preventative medical care�many more than get killed in terrorist attacks.Thousands of Americans are dying prematurely because they lack access to routine, preventative medical care�many more than get killed in terrorist attacks.

25. 40% of our health care premiums go to waste, administrative overhead, and medical errors or unneeded procedures. �Health Care 101�; GMC Administrative overhead in Canada = $307 per person; USA = $1,059. New England JOM $17 to $29 billion annually is the cost of preventable medical errors in lost income, lost production, health care. �Health Care 101� Waste Much waste and medical errors are caused by primitive record-keeping: multiple silos of hand-written paper medical records in separate offices. Multiple physicians treat the same patient in mutual ignorance of each other, relying on patient memory.Much waste and medical errors are caused by primitive record-keeping: multiple silos of hand-written paper medical records in separate offices. Multiple physicians treat the same patient in mutual ignorance of each other, relying on patient memory.

26. Fragmentation � . . . The US health system is highly fragmented among multiple payers, hundreds of thousands of providers often functioning in isolation, and patients with different levels of private and public coverage or no coverage at all. Such complexity and fragmentation drives up administrative expenses as well as care costs.� Page 9; GAO report, May 2004 A myriad of benefit packages, payment systems, authorization requirements increase cost and reduce efficiency. There is no incentive for providers and insurers to work together to reduce costs. In fact, insurers hire firms to minimize their payouts to hospitals and hospitals hire firms to try to get money from insurers. Our health care dollars at work! A myriad of benefit packages, payment systems, authorization requirements increase cost and reduce efficiency. There is no incentive for providers and insurers to work together to reduce costs. In fact, insurers hire firms to minimize their payouts to hospitals and hospitals hire firms to try to get money from insurers. Our health care dollars at work!

27. Fragmentation Places you pay for Health Coverage: Federal Taxes Medicare Medicaid Healthcare for: Active Military, Veterans, Government Employees, Prisoners Homeowners Insurance Auto Insurance (for people injured in car accidents) Liability insurance for businesses Local Taxes Insurance for municipal & state employees, teachers, etc. Individual Health Insurance Premiums, Deductibles, Co-pays At least $14 billion in health care reserves in Michigan The average person pays for healthcare in more than 7 places.The average person pays for healthcare in more than 7 places.

28. What can we do? The very problems that make U.S. health care intolerable maker reform more likely. The very problems that make U.S. health care intolerable maker reform more likely.

29. Join all other economically advanced nations in making health care a right The first and crucial step is universal access to medical care.The first and crucial step is universal access to medical care.

30. Proposed 2008 Constitutional Amendment The State Legislature shall pass laws to make sure that every Michigan resident has affordable and comprehensive health care coverage through a fair and cost effective financing system.� The legislature is required to pass a plan that, through public or private measures, controls health care costs and provides for medically necessary preventive, primary, acute and chronic health care needs. The amendment will require the legislature to act to see that everyone is provided with health care. Polls have shown that the majority of people in the US support universal health care. But, when it comes to deciding what kind of plan, the majority dissolves. Therefore, our strategy is to get that agreement on universal health care in law, and then let the legislators, stakeholders, and consumers figure out how to get to the outcome we all want.The amendment will require the legislature to act to see that everyone is provided with health care. Polls have shown that the majority of people in the US support universal health care. But, when it comes to deciding what kind of plan, the majority dissolves. Therefore, our strategy is to get that agreement on universal health care in law, and then let the legislators, stakeholders, and consumers figure out how to get to the outcome we all want.

31. Security lies in the Constitution! Almost 500,000 signatures are needed to put an amendment on the ballot. Volunteers are needed to collect signatures. Help make Michigan the first state in the Union to declare Health Care is a right.

32. House Concurrent Resolution 22 The first ever resolution in the Michigan legislature that would lead toward HEALTH CARE FOR ALL. House Concurrent Resolution (HCR) 22 provides for � . . . The commitment of the Michigan Legislature to the development of a health care system that provides comprehensive coverage to all residents...�

33. HCR 22 Current Status The House Insurance Committee passed this resolution on May 24, 2007! The Whole House passed this in August Current Status: This resolution is being considered by the senate. Meet with your State Senator and ask them to support SCR 22! This is a reason to be optimistic. Many legislators want universal access to care. This is a reason to be optimistic. Many legislators want universal access to care.

34. Michigan Health Insurance Access Advisory Council [MHIAC] Another reason for hope is the formation of MHIAC. Members include small business groups, chambers of commerce, unions, insurance companies, Gamaliel, MichUHCAN, health care provider groups, and others. All have agreed to work together to create a universal health care plan for the state. This is another reason to be optimistic. See MHIAC�s membership at www.MichUhCan.com. Organizations which are �players� in health care are represented. Everyone recognizes the problems in health care coverage and everyone wants a solution. If you want to help your organization can join the Council and participate in committee work and other work which will create our uniquely Michigan solutions!This is another reason to be optimistic. See MHIAC�s membership at www.MichUhCan.com. Organizations which are �players� in health care are represented. Everyone recognizes the problems in health care coverage and everyone wants a solution. If you want to help your organization can join the Council and participate in committee work and other work which will create our uniquely Michigan solutions!

35. What You Can Do Endorse the 2008 Healthcare for All Ballot Initiative. Collect signatures on the petition. Join MichUHCAN and/or donate to the ballot initiative campaign, �Health Care For Michigan�.

36. To Join/Donate/Volunteer: Check payable to �MichUhCan� www.MichUhCan.com 734-812-0664 Check payable to �Health Care For Michigan�. www.HealthCareForMichigan.com 313-655-7945