Transcript Slide 1

For Patients, Not for Profits
A Single-Payer National Health
Insurance Program
(HR 676)
www.SiCKOCure.org
www.pnhp.org
United States:
46 Million Uninsured
But simply covering them with
existing policies is not a solution.
America’s Underinsured
Proportion of Americans Going Without Care due to Costs, 2005
(skipping doctor visit, specialist appointment, treatment or prescription when needed)
Insured
Insured, Gap in Coverage
70
60
60
50
40
30
28
20
10
0
Source: Commonwealth Fund Biennial Health Insurance Survey, 2005
59
Uninsured
Medical Bankruptcy
• Illness and Medical Bills Contribute to HALF of all
Bankruptcies.
Insurance Status at Onset of Illness
24.3%
• Of those, more than threequarters had insurance when they
got sick.
75.7%
Uninsured
Source: Himmelstein, Health Affairs 2005 (state estimates provided by author)
Had Insurance
Rising Costs = Fewer Benefits = Under/Uninsurance
Proportion of Americans Covered by Employer Insurance
65.0%
63.0%
61.0%
59.0%
57.0%
55.0%
2000
Source: US Census
2001
2002
2003
2004
2005
What Does This Mean?
Lesson #1: Simply Expanding Existing Private
Insurance Policies Is Not a Solution.
Current Private Insurance Policies Offer Inadequate
Protection.
Any Gains in Coverage Will Be Quickly Offset as
Costs Rise and Employers Shed Benefits.
What Does This Mean?
Lesson #2: Any Real Solution to the Health
Crisis Must Do Two Things:
1)
Offer Coverage More Comprehensive than that
Currently Available on the Private Market.
2)
Control Costs so that Benefits are Sustainable.
Life Expectancy, 2003
(Data in Years)
79.4
78.1
79.7
79.9
Canada
Italy
80.2
78.4
77.2
U.S.
U.K.
Germany
France
Source: Organization for Economic Cooperation and Development (OECD)
Sweden
Infant Mortality, 2003
(Deaths in first year of life per 1,000 live births)
8
7
5.4
4.8
4.3
4
4.2
3.9
3.1
0
U.S.
Canada Australia
Italy
Source: Organization for Economic Cooperation and Development (OECD)
Germany France
Sweden
International Health Spending
U.S. Public Spending is Greater than Other Nations’
Public/Private Spending Combined
Per Capita Health Spending, 2004
$6,000
$4,000
$2,000
Source: OECD 2004; Japan and Germany data are from 2003
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Insurance Companies = Paperwork Waste
•Billing
•Marketing
•Underwriting
•Co-Payment Processing
•Eligibility Determinations
•Utilization Reviews
•Provider Administrative Staff
•Employer Benefit Administration
Growth of Physicians and Administrators
1970-2005
3000%
2500%
2000%
1500%
1000%
500%
0%
1970
1975
1980
1985
Physicians
Source: Bureau of Labor Statistics and NCHS
1990
1995
Administrators
2000
One-Third of Health Spending is
Consumed by Administration
31%
Administration
All Other
Potential Savings: $350 billion per year
Enough to Provide Comprehensive Coverage to Everyone
Source: Woolhandler, et al, New England Journal of Medicine, August 2003 & Int. Jrnl. Of Hlth. Services, 2004
Financing Single-Payer
Medicare
Medicaid
Payroll Tax
Single-Payer
Health Care
Fund
$$$
Income Tax
Bonus: Negotiated formulary with physicians, global budget for hospitals,
increased primary and preventive care, reduction in unnecessary high-tech
interventions, bulk purchasing of drugs and medical supplies =
long term cost control.
Single-Payer Benefits

Comprehensive Coverage for all medically necessary
services (doctor, hospital, long-term care, mental health, vision, dental, drug, etc.)
in a single-tier system.

Free Choice of doctor and hospital.

Health Workers Unleashed from corporate dictates
over patient care.

Hospitals guaranteed a secure, regular budget.
Only Two Paths to Reform
1.
Preserve Private
Insurance Companies
and their Waste
2.
Create a National
Health Insurance
System
“Save the Insurance Companies”
A Bipartisan Consensus
National Health
Program
Private Insurance
Tax Credits
Subsidy and Individual Mandate Schemes
(The Edwards and Obama Plans)

Substandard Coverage: forces the uninsured to buy defective
insurance industry products that are already causing families to
face bankruptcy and go without needed care.

Unaffordable: Without the savings achievable with single-payer,
taxes must raised or funds diverted from other needy programs.

Micro-coverage, Macro-costs: Preserves wasteful private
insurers and adds yet another layer of state administrative waste.
Rather than provide care to the uninsured through a relatively
efficient program like Medicare, the plan launders tax dollars
through wasteful private insurers.

No Realistic Cost Control: Any gains in public coverage will be
unsustainable due to rising costs.
“Sounds Great, but it’s
not politically feasible”
2/3rds of population want it
Many (probably most) physicians want it
Business community is now realizing the
need for it
“If done right, health care in America could be dramatically better with true
single-payer coverage.”
-Ben Brewer, WSJ, April 18, 2006
“[single-payer] is an idea that's so easy to slam politically yet so sensible for
business that only Republicans can sell it! …it may take a Republican President
to bless the socialization of health spending we need.”
-Matt Miller, Fortune, April 18, 2006
CNBC / MSN Money
“Think, as a small business, how you could benefit from a single-payer system:
you wouldn’t lose potential employees to larger firms that offer more attractive
health benefits; health insurance costs would cease to be a line item in your
budget. A serious illness befalling you or an employee wouldn’t be a companywide financial crisis. You might even save money.”
-Joseph Antony, CNBC / MSN Money, Winter 2003
“A Step Towards Universal Coverage”
or The Definition of Insanity?
Other States That Have Taken “Steps”
Uninsured at Time
Uninsured 2005
Hawaii (1974)
82,000
116,000
Massachusetts (1988)
494,000
617,000
Oregon (1989)
400,000
578,000
Tennessee (1992)
687,000
835,000
Minnesota (1992)
350,000
430,000
Maine (2003)
133,000
142,000
Is “The Perfect the Enemy of the
Good?”
The Radical and the Republican
“Many of Lincoln’s admirers have painted him as a man who
wanted exactly what the abolitionists did but cannily waited for
a perfect moment to achieve it. [In fact], radicals like Douglass
set an agenda Lincoln gradually adopted as his own. Without
abolitionists, there would have been no Lincoln.”
- James Oakes, Historian, UC Berkeley
Single-Payer: “Politically Feasible?”
Other “Politically Infeasible” Movements
Abolition of Human
Slavery
(1600s)
Women’s Suffrage
Movement
(1840-1920)
Civil Rights Act
(1964)
What You Can Do
•Join Up with the campaign for HR 676 at www.sickocure.org. Use the resources on
the site to educate yourself, your family and your friends about the single-payer
solution.
•Sign the Citizens’ Petition for single-payer national health insurance (on the
website).
•Contact your Members of Congress to tell them you support HR 676, and they
should too.
•Write an Op-Ed or Letter to the Editor of your local paper. You can find tips,
templates and examples at www.sickocure.org.
•Bring Materials and Talk to your church, labor, community or other group about
the single-payer solution. The SickoCure website includes sample resolutions that
your group can endorse and a copy of this slideshow you can use.