Transcript PNHP Proposal Slides - Physicians for a National Health

PNHP Plan Principles
•
Access to comprehensive health care is a
human right
•
The right to chose and change one’s
physician is fundamental
•
Pursuit of corporate profit and personal
fortune have no place in caregiving
•
In a democracy, the public should set
health policies and budgets
PNHP Plan
Eligibility & Coverage
• Hospital Payment
• Payment for Physicians and Outpatient
Care
• Long-Term Care
• Medications and Supplies
• Capital spending, Health planning, Profit
• Funding
•
Eligibility & Coverage
•
Single plan , everyone in, nobody out
covers all medically necessary services
•
Long-term care, mental health, dental,
drugs & supplies
•
No co-payments or deductibles
•
Portable
Hospital Payment
•
Monthly lump sum for operating expenses
•
No operating expenses used for
expansion, profit, marketing, major
capital purchases
•
Capital expenditures from NHI fund based
on community need
•
For-profit hospitals converted to not-forprofit
Payment for Physicians and
Outpatient Care
Three payment options:
•
Fee-for-service (eg Polyclinic, Dr. X)
•
Salaries within institutions receiving
global budgets (eg Swedish)
•
Salaries within capitated groups (eg GHC)
Long-Term Care
•
Cover disabled of all ages
•
Home and nursing home care
•
Local public agency coordinates, global
budgets
•
For-profit NH & agencies converted to
NFP
•
Training, support, finances for family
caregivers
Medications and Supplies
•
Cover all medically necessary prescription
drugs and medical supplies based on
national formulary
•
Expert panel establishes & updates
formulary
•
Negotiated drug & equipment prices
Capital spending, Health planning,
Profit
•
NHP budget funds construction of health
facilities and purchase of expensive
equipment
•
Regional health planning boards allocate
capital funds
•
Compensation for owners of investor
owned facilities and equipment
Funding
•
NHP pays for all medically necessary
health services, with total expenditures
set at same proportion of GDP as year
prior to NHP
•
Public money now routed through private
insurers, employer contribution, plus
income & payroll taxes
•
Mix of taxes used to raise funds is a
matter of tax policy separate from
organization of health care
Similarities between
HR 676 and HR 1200
Universal coverage- “everyone in, no one
out”
• Portability (state to state and job to job)
• Choice of providers
• Mechanisms for quality control and cost
control
• Comprehensive benefit package
(inpatient, outpatient, emergency,
preventive, mental health, substance
abuse, prescription drugs, long term care,
dental, etc.)
•
Differences between
HR 676 and HR 1200
•
HR 676: National program, administered pricing
• Payment predetermined on average provider
cost.
• “Efficient” providers expected to make money
while inefficient providers would lose.
• Makes "for profit" healthcare illegal.
•
HR 1200: State-based program, national standards
• Federal govt. collects taxes, distributes to States
based on risk-adjusted percentage of
population.
• Federal Board establishes required benefits
package.
• Each State develops a program conforming to
national guidelines, regulations, and required
covered services.