Health Care Facts and Guiding Principles for Health Care Reform

1. Health Care Facts and Guiding Principles for Health Care Reform Public Employees Union, Local #1

2. Health Care Spending as a Percentage of Gross Domestic Product (GDP) Source: Health Care Costs 101, 2005 – California HealthCare Foundation

3. How Does the U.S. Compare? • The U.S. spends a much greater portion of private dollars on health care than any other country • In 2002, the U.S. government spent $2,364 per capita on health care (primarily Medicare and Medicaid) while the governments of Canada ($2,048) and France ($2,080) spent less

4. Americans are paying more out-of-pocket than ever before for health insurance • Deductibles and premiums are increasing, limiting the access to care. In California the percentage of premiums paid by workers for a family plan has increased from 23% in 2000 to 27% in 2004 Priced Out: Health Care in California , John Garamendi 2005

5. Growth in Private Health Insurance Premiums 2000-2004 Source: Health Care Costs 101, 2005 – California Health Care Foundation

6. Health Care Costs in the News

8. Did You Know… 1/2 of all bankruptcies in the United States now relate to medical costs even though ¾ of the bankrupted families had health coverage at the time of sustaining the injury or illness. Going for Broke: Newsweek August 31, 2006

9. OUR GUIDING PRINCIPLES FOR HEALTH CARE REFORM Public Employees Union, Local #1 believes that healthcare for all is a human right not a luxury for those who can afford to pay. In keeping with our Union’s values we reject the assertion that the solution to escalating costs is to continue the reduction of healthcare for our communities. Instead, we must demand nothing less than healthcare for all. To accomplish healthcare for all over corporate interests, Local #1 will actively endorse reform of America’s healthcare delivery and financing system, with an emphasis on supporting legislation before the California Legislature that will establish California as a model for National Universal Health care. Toward this goal we are guided by the following principles:

10. Guaranteed Coverage for Everyone • Coverage shall not be denied for any reason. • Coverage shall be portable and continuity of care assured whenever feasible. • Coverage shall be provided without regard to employment status. • Coverage shall insure patient privacy as per H.I.P.A.A. laws

11. Guaranteed Medically Necessary Benefits • Universal benefits shall provide timely access to all medically necessary care. • Benefits shall emphasize and encourage preventative care, including immunization of children and prenatal care. • Chronic illness shall be managed to promote better health and control costs. • Emphasis shall be placed on at-risk populations and the elimination of economic and racial disparities in healthcare and health status.

12. Fair Financing of Healthcare System • Generate funding for universal healthcare by consolidating different types of private insurances and government healthcare programs. • Reduce administrative costs through the universal program and redirect the funds saved to treatment costs. • Establish state and/or federal government as the authority to establish fair healthcare provider reimbursement rates. • Creates universal financing based upon the ability to contribute without creating an undue burden on individuals or employers. • Financial risks shall be spread as broadly as possible while seeking to eliminate unnecessary costs and promote efficiency and fairness.

13. Meaningful Cost Controls • Ensure cost effectiveness and accountability by standardization of pricing of medical supplies, pharmaceuticals and hospital rates. • Ensure that provider and hospital practices are oriented toward efficient delivery of quality of care as medically necessary. • Ensure that administrative costs are directly related to the efficient and effective delivery of the universal healthcare system.

14. Freedom to Choose Providers • Covered individuals shall be able to choose their doctors and other healthcare providers, assuming they are available and their practice allows. • Publicize information to allow individuals to make informed decisions about provider choices based upon hospital and physician practices, utilization reviews and treatment outcomes.

15. Quality Healthcare • Improve the quality of care by reducing medical errors and avoiding unnecessary hospitalizations. • Advance strategies that improve quality and efficiency across the healthcare system, such as evidence-based best practices and health information technologies and electronic record systems. • Create incentives for providers to improve quality of care while delivering such care in a cost efficient manner.

16. Elder and End of Life Care • Provide integrated services that reduce costs and maximize opportunities for individuals to receive in-home assistance and community-based care, rather than in hospitals and nursing homes. • Be sensitive to and respectful of the patient’s and family’s wishes • Provide access to any treatment that will realistically be expected to improve the patient’s quality of life. • Provide access to palliative care and hospice care. • Respect the right to refuse treatment. • Respect the physician’s professional responsibility to discontinue some treatments when appropriate, with consideration for both patient and family preferences.