Universal Health Care: A Necessary Safeguard of Human Life and Dignity

1. "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

2. Universal Health Care: An American Dream or Reality?

3. Goals for Presentation • CONSEQUENCES OF BEING UNINSURED • US VS OTHER DEVELOPED COUNTRIES • WHERE’S THE WASTE? • WHAT IS SINGLE PAYER?

4. CONSEQUENCES OF BEING UNINSURED

6. Who Are The Uninsured?

7. 18,314 Adult Deaths Annually Due to Uninsurance

8. Unmet Health Needs of the Uninsured

11. US vs. OTHER DEVELOPED COUNTRIES

15. 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.

17. The U.S. continues to trail most other developed nations in key health indicators, despite spending far more on care.

19. Despite spending far more on health care than any other nation, Americans do not get large amounts of care.

24. Number of Nurses per 1000 Population

25. Percent of Population withGovernment-Assured Insurance

27. WHERE’S THE WASTE?

28. US Drug Spending

29. Drug Company Profits

30. 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.

31. Government Funds Most Academic Research

32. Drug Companies’ Cost Structure

33. 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

35. Private insurers’ High Overhead

36. Insurance Overhead 2001

37. Who Pays for Health Care? Regressivity of US Health Financing

38. Is there any mystery why many Blue Cross executives are anxious to turn for-profit and join Anthem (a former Blue Cross plan).

39. Health Costs as % of GDP: US & Canada

40. WHAT IS SINGLE PAYER?

41. 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

42. The Healthcare Americans Want • Guaranteed access • Free choice of doctor • High quality • Affordability • Trust and respect

43. The 4 principles of single payer: • Access to comprehensive health care is a human right. • The right to choose and change one's physician is fundamental to patient autonomy. • Pursuit of corporate profit and personal fortune have no place in caregiving and they create enormous waste. • In a democracy, the public should set overall health policies.

44. 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

45. 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

46. 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

47. Payment for Physicians and Outpatient Care: 3 Options • fee-for-service • salaried positions in institutions receiving global budgets • salaried positions within group practices or HMOs receiving capitation payments

48. 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.

49. 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

50. 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