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Health Care in the United States

Health Care in the United States. FTQ Delegation Report March 11 – 12, 2008 Washington DC. Original Report presented to the General Council of the FTQ. 2008-03-18. Participants Pierre Laliberté FTQ Danielle Legault SQEES 298 Simon Berlin SEPB Daniel Mallette Steelworkers

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Health Care in the United States

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  1. Health Care in the United States FTQ Delegation Report March 11 – 12, 2008 Washington DC Original Report presented to the General Council of the FTQ 2008-03-18

  2. Participants Pierre Laliberté FTQ Danielle LegaultSQEES 298 Simon Berlin SEPB Daniel Mallette Steelworkers Martin Lambert CAW Objectives Learn more about the health care system in the U.S. and how it works Assess the financial burden on the American working class Exchange ideas around the challenges confronting unions in the U.S. and in Quebec with regards to health care Learn about the goals and obstacles of U.S. unions striving for American health care system reform and compare Presidential candidates positions on health care. The Delegation

  3. Our union hosts • SEIU – Service Employees International Union (U.E.S.): • 1.9 million members; the largest union in the States • United Steelworkers: • 1,800 Local unions in Canada, the States and in the Caribbean • AFSCME – American Federation of State, County and Municipal Employees: • 1.4 million members

  4. Medicaid Jointly financed by the States (30%) and the Federal government (70%) Provides coverage to only the very poor (Max $18,000/year/4 pers.) State Child Health Insurance Plan (SCHIP) provides coverage to 6 out of the 9 million children without coverage Medicare Jointly financed by the States (30%) and the Federal government (70%)Provides coverage to people age 65 and over (37 million) who have contributed for at least 10 years, and to the disabled (7 million) 80% of the costs covered  MediGap Long term health care is not covered Accounts for 13% of the Federal budget and 19% of all health care expenditures Two Public Programs

  5. Medicare: Benefits and Cost SharingA few Elements – 2007

  6. Medicare: Benefits and Cost SharingA few Elements – 2007

  7. Medicare: Benefits and Cost SharingA few Elements – 2007

  8. and for the others…. • If one is not eligible for public programs, one has to purchase private insurance • 60% of U.S. workers rely on health insurance coverage paid for by their employer • 40% have no public protection as their income exceeds the minimum allowable while being too poor to purchase private insurance. They are for the most part workers employed by small and medium size companies. • If they are sick, they need their VISA card if they want to be treated, that is, if they have one…

  9. The U.S. System - Some Numbers • 17% of the du GDP ($2.1 trillion) is devoted to health care(17% of Americans do not qualify and have no insurance) • Workers spend a minimum of 10% of their income to health care. On average, $12,000/year/family

  10. The U.S. System - Some Numbers (cont’d) • The U.S. system costs twice as much as the Canadian system costs per capita (in 2007 = $6,697 for the U.S. compared to $3,326 for Canada) • 50% of personal bankruptcies are caused by medical bills. Represent 1 million people of which 50% had private health insurance coverage.

  11. The U.S. System - Some Numbers (cont’d) United States: Is the grass always greener on the other side of the fence?

  12. The U.S. System - Some Numbers (cont’d) “My study raises serious questions about what we’re getting for the $2.1 trillion we’re spending on health care this year. We pay almost twice what Canada does for care, more than $6,000 for every American, yet Canadians are healthier, and live 2 to 3 years longer!” Dr David Himmelstein Associate Professor of Medicine Harvard University2 2 Physicians for a National Health Program, Study shows U.S. residents are less healthy, less able to access health care than Canadians, Press Conference, May 30, 2006 w.pnhp.org.

  13. The U.S. System - Some Numbers (cont’d) • With the 2003 Reform private insurers promised they would offer the same service at 83% of public cost. Today, the same services cost 117% of what public program costs (Medicare) • Half of all health care spending is being used to treat 5% of the population

  14. Health Care Spending per Person

  15. Impacts • 47 million Americans have no health coverage as they cannot afford it • 3 million children have no protection • The number of people without coverage is rising (1.5 million/year) • More and more people gamble with their health (I’ll take my chances!)

  16. What about those who have insurance; are they protected???

  17. Dealing with Insurance Companies • High administrative costs (double) and huge bureaucracy burden • One in three claims is denied • Workers must obtain authorization from the insurance before treatment begins • Some physicians refuse to see insured clients and demand immediate cash payment. Workers have to handle the filing of their claims themselves • Must be healthy to get insurance or… premiums go up …$$$

  18. The Alcoa-USA Case • This employer has what is considered to be the “Cadillac” of health care insurance • Each month workers pay a premium • Workers have a $500 deductible • A coinsurance of 10%, i.e. workers pay $100 out of their pockets for every $1,000

  19. Negotiations • Several large unions face huge challenges at the negotiation table because of the rising costs of insurance • They often have to chose between health care coverage or better benefits or agreeing to concessionary demands

  20. Negotiations (cont’d) • Employers’ goal is to lower their insurance costs through concessions • In some collective agreements (30%) health care coverage is provided through the employer. A rift between retired members and active members is caused when it is time to make a decision.

  21. Employer Based Insurance Coverage

  22. Conclusion • A private system costs more than a public system • Medicare : benefits account for 97% VS 87% in private coverage (and 4% in profits) • Middle class families are getting poorer • Bigger financial problems because of health care costs. People are forced to chose between food or medicine • Injustice and discrimination based on age and health • Major challenges for unions • 10 reform attempts in the last 60 years

  23. Web Sites of Interest • www.kff.org : The Henry J. Kaiser Family Foundation • www.usw.org : « Crucial Issues »on the left of the page, click « Health Care » • www.seiuhealthcare.org • www.elori.org/campaign/ • www.rwf.org/index.jsp : The Robert Wood Johnson Foundation • www.urban.org: Urban Institute

  24. Any Comments or questions?

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