Transcript Medicare For All/Single Payer Assurance

Health Care For All!
Fiscally Conservative, Socially Responsible
Louis M. Schlickman, MD
Idaho Health Care For All
www.idahohealthcareforall.org
Chapter of Physicians for a National
Health Program
www.pnhp.org
“America’s health care system is neither
healthy, caring , nor a system.”
Walter Cronkite
Overview
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Economic Background
Our Strengths
Our Weaknesses and Problems
A Uniquely American Solution
Lower Cost and Increased Efficiencies
What can we do?
Some Background
from the Organization for Economic Cooperation and Development (OECD)
Our Strength
• The best care money can buy
• The best reactive care in the world
– If you are a trauma victim
– If you have an occluded coronary artery
– If you have an operable cancer
– If you are born prematurely
QUESTIONS
• Is this high-tech critical care why we cost
more?
QUESTIONS
• Is this high-tech critical care why we cost
more?
• Do we benefit with our proclaimed more
efficient private financing system?
QUESTIONS
• Is this high-tech critical care why we cost
more?
• Do we benefit with our proclaimed more
efficient private financing system?
• Define an “efficient” health care system?
– A business profit commodity model?
– A health care delivery social model?
– Does health care belong in a commodity market?
Ben Sargent, NYT 2009-09
Our Problem
• Suboptimal preventive/proactive care
• 47 million uninsured in a population of 300
million
• U.S. quality Ranked 37th in the world
• Every 30 sec someone files bankruptcy
• U.S. is the only industrialized country not to
provide universal health care coverage
The Prescription
• Consider Medicare For All/Single Payer
– universal
– guaranteed
– comprehensive
– free choice
– cost-effective
– good for economy
– pride in country
– return dignity to individuals
The Prescription
• Enrollment criteria
–Birth
• Disenrollment requirements
–Death
• EVERYBODY IN, NOBODY OUT!
Prescribed Benefits
• ALL NECESSARY PRIMARY AND SPECIALTY CARE:
– Doctor office/Hospital
– Dental/Vision/Hearing
– Mental health/Substance abuse rehab
– Prescription medications
– Preventive/Wellness care
– Long term care/Home care/Hospice care
– Physical Therapy/Chiropractic
Prescribed Benefits
• NO MORE
– deductibles,
– co-pays,
– co-insurance,
– out of pocket expenses
• MORE CHOICE!
– Go to ANY doctor or ANY hospital in the USA
– No networks or risk of denial of care
The Cost
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Extremely cost effective
Massive risk pool
Everyone contributes, you can’t opt out
Ex. other cost effective public/social services
– fire dept.
– public education
– police dept.
– highway funds
How do we fund Single Payer?
• 2009: current system generates $2.5 Trillion bill.
• 60% already paid for by taxpayer—that’s $1.5
trillion
– Medicare/Medicaid/SCHIP
– Veteran’s Administration/Indian Health Services
– Federal Employee Health Benefits
• 40% is what we (business 20% and individual
20%) also pay to private health insurance
companies
– Premiums, co-pays, deductibles, co-insurance, out of
pocket costs
How do we fund Single Payer?
• $1.5 trillion already paid by taxes stays the
same.
How do we fund Single Payer?
• The other $1 trillion is offset by progressive
tax mechanism:
Funding
• However, we won’t have to pay $1 trillion.
• We can save $300-400 billion just by getting
rid of the administrative waste generated
directly and indirectly by the private health
insurance companies.
• Pay less (or possibly the same) and get much
more
Other Indirect Funding
• Bulk purchasing power for pharmaceuticals
• Eliminate huge CEO salary’s
HMO CEO PAY AND STOCK
HOLDINGS
Tony Auth, The Philadelphia Inquirer, 2009-10-07
OTHER SAVINGS
Perverse incentives cause waste
• Variation in Practice leads to High Rates of
Inappropriate Care
• Preventable Patient Injury and Death
• Inability to “Do What We Know Works”
• Business Model based on Exclusion and Denial
causes Uninsurance (Cost Shifting) and
Underinsurance which lead to Excessive
Overhead
Additional Efficiencies
• Doing Well What Works
– American health systems “get it right” 55% of the
time (NEJM 2003; 348(26):2635-45
– We often fail to do proven things (eg, aspirin in
the ER for MI, beta-blocker at discharge)
– We often do things not proven useful (surgery for
regional pain disorders)
H.R. 676, Rep. John Conyers, Jr.
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HR 676 Healthier and more productive workforce
No more dead end jobs just to keep insurance
Patriotism is a “WE” thing
Health Assurance is not a partisan issue
Private health insurance companies provide
absolutely no value to the health care delivery
process
• The business model of health insurance directly
competes with and antagonizes the delivery of
appropriate health care.
What do Americans prefer?
Phony vs. Real Reform
Phony
• Choice of HMO/insurer
• Coverage = Co-pays,
exclusions etc.
• Security = Lose it if you
can’t work or can’t pay
• Savings = Less care
Real
• Choice of doctor and
hospital
• Coverage = First $,
Comprehensive
• Security = For everyone,
forever
• Savings >$300 bil. on
bureaucracy
David Horsey, The Seattle Post-Intelligencer 2009-10-15
What can we do?
Call Congress today for Single-Payer/Medicare
For All healthcare reform and say:
1) Support Congressman Weiner’s single-payer
amendment to HR 3200
2) Retain Congressman Kucinich’s amendment
for state single-payer options in HR 3200
3) Support S. 703 by Senator Bernie Sanders, VT
All you have to do is go here:
http://tools.advomatic.com/35/hc-n
Resources
• http://www.youtube.com/watch?v=Dv4Aos-TBH8&feature=related
– Great brief summary on YouTube of how Medicare For All
would work.
• guaranteedhealthcare4all.org/ Leadership Conference for
Guaranteed Health Care – The National Single Payer Alliance
has a combined membership of over 20 million people and
includes the following:
– www.idahohealthcareforall.org/ Idaho Health Care For All
– www.Healthcare-NOW.org Healthcare-NOW!
– www.pnhp.org Physicians for a National Health Program
– www.calnurses.org/legislative_advocacy/ California
Nurses Association
– singlepayeraction.org/ Single Payer Action Network
– www.medicareforall.org/pages/Home Medicare For All
You're making this way too hard,
David Horsey, The Seattle Post-Intelligencer, 2009-10-16
This is the end of my presentation.
Thank you for attending.
We will have this power point available
on our website
www.idahohealthcareforall.org
so you can access the links for data
and support of our mission.
Please, stop reading this while I’m
talking to you.
Massachusetts: Required Coverage
(Income > $30k)
• Premium: $4,080 Annually (56 year old)
• $2000 deductible
• 20% co-insurance AFTER deductible is reached
Crimes and Punishments in
Massachusetts
The Crime
The Fine
Violation of Child Labor Laws
$50
Employers Failing to Partially Subsidize a
Poor Health Plan for Workers
Illegal Sale of Firearms, First Offense
$295
Driving Under the Influence, First Offense
$500 min.
Domestic Assault
$1000 max.
Cruelty to or Malicious Killing of Animals
$1000 max.
Communication of a Terrorist Threat
$1000 min.
Being Uninsured In Massachusetts
$500 max.
$982
Drug Companies’ Cost Structure