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wwwmwphaorgjoomlasingle-payer-healthcareppt.ppt

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									"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
•   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
•   Guaranteed access

•   Free choice of doctor

•   High quality

•   Affordability

•   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 medically-
       necessary 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?
•    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

•   Excellent hospitals

•   Enough well-trained professionals

•   Superb research

•   Current spending is sufficient

								
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