Transcript Prescription Drugs and Supplies

"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
Universal Health Care: An
American Dream or
Reality?
Goals for Presentation
• CONSEQUENCES OF BEING
UNINSURED
• US VS OTHER DEVELOPED
COUNTRIES
• WHERE’S THE WASTE?
• WHAT IS SINGLE PAYER?
• CONSEQUENCES OF BEING
UNINSURED
Who Are The Uninsured?
18,314 Adult Deaths Annually
Due to Uninsurance
Unmet Health Needs of the
Uninsured
US vs. OTHER DEVELOPED COUNTRIES
Number of Nurses per 1000
Population
Percent of Population with
Government-Assured Insurance
WHERE’S THE WASTE?
US Drug Spending
Drug Company Profits
Government Funds Most
Academic Research
Drug Companies’ Cost Structure
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
Private insurers’ High Overhead
Insurance Overhead 2001
Who Pays for Health Care?
Regressivity of US Health
Financing
Health Costs as % of GDP: US &
Canada
WHAT IS SINGLE PAYER?
The Healthcare Americans Get
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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
The Healthcare Americans Want
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Guaranteed access
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Free choice of doctor
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High quality
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Affordability
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Trust and respect
The 4 principles of single payer:
1. Access to comprehensive health care is a human
right.
2. The right to choose and change one's physician
is fundamental to patient autonomy.
3. Pursuit of corporate profit and personal fortune
have no place in caregiving and they create
enormous waste.
4. In a democracy, the public should set overall
health policies.
Single public plan would cover
every American for all medicallynecessary 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
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
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
Payment for Physicians and
Outpatient Care: 3 Options
1. fee-for-service
2. salaried positions in institutions receiving
global budgets
3. salaried positions within group practices
or HMOs receiving capitation payments
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.
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
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
How Do We Know It Can Be Done?
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Every other industrialized nation has a healthcare
system that assures medical care for all
All spend less than we do; most spend less than
half
Most have lower death rates, more accountability,
and higher satisfaction
Not a single one has gone to that system, found it
to be worse, and switched back
– NONE
We Have What it Takes
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Excellent hospitals
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Enough well-trained professionals
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Superb research
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Current spending is sufficient