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					                                 Greg Dattilo
Co-Author: Your Health Matters:What You Need
                to Know About U.S. Health Care




       Facts: Not Fiction – What really ails
       the US health care system
Government-            How to Heal the       Consumer-
Driven                Health Care “Crisis”   Driven

Government sets                              Consumer sets price
price of care                                of care

Monopoly: Disallow                           Competition
competition

Focused on the cost                          Focused on quality care
of care and global                           and consumer demand
budget
―It is the commitment of the state to achieve universal
  health coverage for all Minnesotans by the year 2011.
  Universal coverage is achieved when: (1) every Minnesotan
  has access to a full range of quality health care services; (2)
  every Minnesotan is able to obtain affordable health coverage
  which pays for the full range of services, including preventive
  and primary care; and (3) every Minnesotan pays into the
  health care system according to that person’s ability.‖
―It is the commitment of the state to achieve universal
  health coverage for all Minnesotans by the year 2011.
  Universal coverage is achieved when: (1) every Minnesotan
  has access to a full range of quality health care services; (2)
      Guaranteed Issue
  every Minnesotan is able to obtain affordable health coverage
  which pays for the full range of services, including preventive
  and primary care; and (3) every Minnesotan pays into the
  health care system according to that person’s ability.‖
―It is the commitment of the state to achieve universal
  health coverage for all Minnesotans by the year 2011.
  Universal coverage is achieved when: (1) every Minnesotan
  has access to a full range of quality health care services; (2)
   Minimum Benefit Set
  every Minnesotan is able to obtain affordable health coverage
  which pays for the full range of services, including preventive
  and primary care; and (3) every Minnesotan pays into the
  health care system according to that person’s ability.‖
―It is the commitment of the state to achieve universal
  health coverage for all Minnesotans by the year 2011.
  Universal coverage is achieved when: (1) every Minnesotan
  has access to a full range of quality health care services; (2)
  every Minnesotan is able to obtain affordable health coverage
  which pays for the full range of services, including preventive
  and primary care; and (3) every Minnesotan pays into the
  health care system according to that person’s ability.‖
 Familyof four earning $61,620 or
 less cannot spend more than 6%
 ($3,700) on health care
 ◦ Premium, co-pays, deductibles, co-insurance,
   out-of-pocket expenses
 ◦ Minnesota taxpayers will subsidize any
   spending greater than $3,700
 Familyof four earning $82,608 or
 less cannot spend more than 8%
 ($6,600) on health care
 ◦ Premium, co-pays, deductibles, co-insurance,
   out-of-pocket expenses
 ◦ Minnesota taxpayers will subsidize any
   spending greater than $6,600
 Create the new Health Insurance Exchange
 Create ―advanceable, refundable tax credit for
  Minnesotans.‖
 Allow employees to use an employer cash
  voucher to purchase subsidized, government-
  defined health plans through the Exchange
   At its beginning: Incents employers to shift
    their premium cost to taxpayers
    ◦ $10,000 premium, with employer paying $8,000
    ◦ Now employer can pay $5,000 and let the taxpayers subsidize
      the balance
   Eventually, forcing creation of a payroll tax to
    support the cost overruns
 Become the state’s H.R. department –
  reporting to the state about employee health
  insurance status
 Garnishing wages
 Accounting for and paying premium to the
  Exchange
 Employers do not want this - Survey
 Moving to the lowest benefit plan offered
  through the Exchange
 Employees could pay more of their own
  premium, and be incented to greater
  utilization
 Could eliminate the use of HSA-qualified health
  plans for middle- and low-income residents
   Non-government
    employers insure 2.25
    employees for the same
    cost as government
    insures only one of
    their employees
   Minnesota employs about 50,000 people who are
    enrolled in its health insurance*
   During 2008, Minnesota will pay more than $460
    million in premium for its enrolled employees
    (Employees pay $43 million—8.5%—of the total
    premium)
   Average benefit cost per hour is $4.44 compared to
    $1.79 for private employers (2.5 times greater)


                  * Bruce Yurich, MN Department of Employee Relations
   With a private plan for state employees, the cost
    savings of $275 million could pay the health insurance
    cost of 74,000 low-income residents… with no other
    state subsidy


 So   what is the reason that government is
    trying to reform private health
    insurance?
 Reasons   for increase in uninsurance:
 ◦ 1- Decrease in employer-based health insurance
   coverage
 ◦ 2- Changes in employment
 ◦ 3- A shift in income distribution
 ◦ 4- Change in the composition of the
   Hispanic/Latino population
54 Percent of
  uninsured
  eligible for
 government
health plans
  but didn’t
  sign up!
 Insure  the uninsured
 Allow agents to enroll people into
  government health plans
 Sell affordable health insurance – not
  prepaid health care
   Traditional health plan             Consumer Directed
    ◦ $15-$20 co-pay, 100%               Health Plan
                                         ◦ $2,000-$2,500 deductible,
                                           100% HSA plan
    3.36%

Premium change, 1/1/07 to 12/31/07                -5.14%

           *Combined, small group pool: BC-BS, HP, Medica, PreferredOne
Do you own a car?




We don’t have health insurance
 We have prepaid health care
   Claritin
    ◦ $75 a month ($900 a year)
    ◦ Over the counter at $25
      ($300 a year)
    ◦ Generic Loradatine

     $15 a year
   Lasik Surgery
    ◦   $10,000 an eye in 1991
    ◦   $2,000 an eye in 2007*
    ◦   As little as $300 an eye
    ◦   Financing available
    ◦   Elective surgery usually paid out of pocket – no
        insurance coverage




                     * Actual cost of a surgical package: Allaboutvision.com
 Changing behaviors
  ◦ Paying attention to cost
  ◦ Taking responsibility for health
 Voluntary health insurance
 Financial incentive
 High Deductible Health Plans
 Health Savings Accounts (HSAs)
 ◦ Pre-tax money


         Catastrophic insurance plan HDHP

             Health Savings Account
One third
  did not
previously
   offer
  health
insurance
 Healthier   people
 Healthier   people

 Peopledirectly paying for more of
 their own health care cost out of
 pocket
   Personal financial stake in health care
    ◦ Health, price and value conscious
    ◦ More interactive & cooperative with
      doctors
    ◦ Wants instant, useful information



                  Or….
 Leaveit to others – governments –
 to decide how best to live, to eat,
 to exercise, to take care of oneself.
   Which do you prefer?
Government-driven
Government           Consumer-driven




46 cents              54 cents

7.2% of GDP         8.8% of GDP
   Loss of Jobs

     45 cents
   Which do you prefer?
Government-driven    Consumer-driven




 Basic Health Care

    46 cents
   Which do you prefer?
Government-driven        Consumer-driven




 Basic Health Care   Comprehensive Health Care
    46 cents               54 cents
   Which do you prefer?
Government-driven   Consumer-driven




 Waiting Lines      Health Care Access

    46 cents          54 cents
   Which do you prefer?
Government-driven    Consumer-driven




  Loss of Jobs      Jobs – Jobs - Jobs
    46 cents           54 cents
Government     Free
             Market
                                    Greg Dattilo

Co-Author: Your Health Matters:What You Need
                to Know About U.S. Health Care




       Facts: Not Fiction – What really ails
       the US health care system

				
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