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Austerity, Unaffordability, and Universal Health Care

The impact of austerity and other social policies on health care at home and internationally Workshop PNHP National Conference 2013 Jacob Bor PhD Adam Gaffney MD. Austerity, Unaffordability, and Universal Health Care. Change in GDP. 6/10: ECB CALLS FOR “FISCAL CONSOLIDATION”. BAILOUT.

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Austerity, Unaffordability, and Universal Health Care

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  1. The impact of austerity and other social policies on health care at home and internationallyWorkshopPNHP National Conference 2013Jacob BorPhDAdam Gaffney MD

  2. Austerity, Unaffordability, and Universal Health Care

  3. Change in GDP 6/10: ECB CALLS FOR “FISCAL CONSOLIDATION” BAILOUT Source: World Bank, http://data.worldbank.org/indicator/NY.GDP.MKTP.KD.ZG

  4. Austerity and Health Care “The massive deterioration in the underlying fiscal position over the last decade can largely be attributed to an expansion of social spending (particularly health and pension expenditures)…” • IMF Country Report No. 12/57 “Greece: Request for Extended Arrangement Under the Extended Fund Facility,” March 2012

  5. Men < 65: Suicide, Infectious Dz, and Homicide Mortality Kondilis E, Giannakopoulos S, Gavana M, Ierodiakonou I, Waitzkin H, Benos A. Economic crisis, restrictive policies, and the population's health and health care: the Greek case. American journal of public health 2013;103:973-9.

  6. Gili M, Roca M, Basu S, McKee M, Stuckler D. The mental health risks of economic crisis in Spain: evidence from primary care centres, 2006 and 2010. European journal of public health 2013;23:103-8.

  7. I. Cuts

  8. II. Copays

  9. Portugal: User Fees Barros PP. Health policy reform in tough times: the case of Portugal. Health policy 2012;106:17-22.

  10. III. Corporatization

  11. How to Unravel Universal Health Care: Cuts, Copays and Corporatization • Reduce Supply • Austerity/Cuts • Reductions in services • Privatization • Reduce demand • Deterioration in quality • Rise in user fees • Exclude access (the immigrants, the wealthy)

  12. Transatlantic Parallels • AMERICA AND THE ACA • The “Quiet Revolution” in cost sharing • Undocumented immigrants still excluded • Private insurance protected/subsidized • Cuts: Safety net hospitals • EUROPE AND AUSTERITY • New and rising copayments • Spain: Undocumented newly excluded • UK: New role for increased private care; Spain: Privatization of hospitals, etc. • Cuts: All levels

  13. A different direction?

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