HealthCare/Prescriptions for Californians:
There Is a Train Wreck
Ahead – in fact, it’s here!
This program operates under a grant from the California Wellness Foundation
What is the Healthcare Train Wreck?
-- and how can we
talk about it so
people “get it?”
Just the Facts, Ma’am!
High Cost of American Medical Care (vs.
the rest of the world)
We are number 37 in the world for med.
Outcomes (between Costa Rica/Slovenia)
Who gets medical care? (hint: rich, good
insurance, children covered by SCHIP,
Medicare recipients, Medicaid recipients)
Who doesn’t get medical care?
(Underinsured and uninsured, plus people
kicked out by insurers)
The Uninsured: 47 Million and growing (7
million in California)
Medicare Part D is still a mess and getting
Other Prescription Drug Issues: Errors and
Why don’t they get health care?
Those who work part-time jobs: temp,
People who are really sick
Can we agree on a set of universal
Every working parent must be able to take
their kids to the doctor
Medical decision must be made by us and
our doctors, not insurance company bean
No one should profit from people’s
Pricing for care must not be a secret
We should not be herded to a “panel” of
physicians because it’s good for insurance
A philosophical divide
Guaranteed, affordable health care vs.
forcing people to buy insurance
Per Capita Spending on
Health Care – 2004
(How Does GM Compete In A Global Market?)
$4,000 $3,165 $3,159 $3,041
$3,000 $2,825 $2,546
Source: Organization for Economic Co-Operation and Development (OECD) Health Data 2006
(in U.S. dollars adjusted for purchasing power parity) 8
Health care costs, vs. earnings and
20 Health Insurance Premiums
18.0 Workers Earnings
Source: KFF/HRET Survey of Employer-
Sponsored Health Benefits: 2005
Note: Data on premium increases reflect the
cost of health insurance premiums for a
family of four. Historical estimates of
workers’ earnings have been updated to
reflect new industry classifications (NAICS).
Remember Part D?
Did it really work?
Who’s happy now?
Can the mess be cleaned up?
Medicare Part D
can be deducted from your SS
check or paid directly to plan
No coverage during donut hole
Still pay premiums, even though no
Part D: Who Wins??
Average senior: saved $9 per month
Jay Gellert, Health Net: $11,639,834
William McQuire, United Health
Larry Glasscok, Wellpoint (Blue
Edward Harnway, Cigna, $12,373,300
Insurance Company profits increased
234% from 2000 to 2004
Modern Healthcare: April and July Issues 2006
• No negotiating for best prices like VA and
• States can’t regulate insurance plans
• Late Enrollment Penalty: 1% penalty per
month and the penalty lasts forever
• Some retirees lost their creditable coverage
• Originally, insurance companies could change
prices, formularies, co-pays, deductibles at will,
but not you!
It’s a legislative problem and will require
a legislative solution
Opening up US prescription drug pricing
to world competition and free trade
(Prescription Drug Importation debate)
Don’t vote for anyone who is not part of
No More Vioxxes!
Register all clinical trials and make results public
Regulation of industry marketing
Best Buy Drugs (www.consumersunion.org)
Drug Effectiveness Review Project (DERP):
Oregon Health & Science University Evidence-
Based Practice Center. Medication Errors Panel
Report (CA State Cap.)
Rx Marketing to Doctors
Industry spends $12 B/year on drug marketing
to MDs, or $13,000/doctor
There is 1 sales rep for every 5 MDs
Gifts, lunches, trips, educational grants,
entertainment, free samples
Even small gifts create obligation and influence
Free samples create loyalty to brand and
unwillingness to use generics (30-80% lower cost)
Doctors are paid to promote
expensive new drugs and off-
The FDA and the Pharmaceutical
US drug prices are the highest in the
world and getting worse. We paid 81%
more for brand drugs (average) than
Switzerland, Britain, Germany, Canada,
Sweden, France, and Italy.
FDA ties to Pharma (Tauzin)
What is to be done?
“I don’t believe there’s any
problem in this country, no
matter how tough it is,
that Americans, when they
roll up their sleeves, can’t
When did other countries get guaranteed,
accessible healthcare systems?
Germany 1883 Canada 1966
Switzerland 1911 Denmark 1973
New Zealand 1938 Australia 1974
Belgium 1945 Italy 1978
UK 1946 Portugal 1979
Sweden 1947 Spain 1986
Greece 1961 South Africa 1996
Japan 1961 Thailand 2006
What will it take to win? Everybody
in one risk pool!
Voters need to provide politicians a
safe haven so they can do the right
YOU and your family and friends! 21
How do we talk about Health care?
• Iraq War, Economy, Healthcare. Combine
• Voters are concerned will cost more
• Voters are frightened and resent that
insurance companies deny coverage
• Voters support reform proposals in principle —
but are afraid they will lose what they have.
• The concept of ―quality affordable health
care‖ is more appealing than ―universal
• Voters strongly support Medicare but
believe it has problems. (Part D has hurt us)
• Core value – pursuit of American Dream, our
country’s destiny, family’s well-being and future.
• Voters use moral terms – no American should
be denied health care.
• Voters see it as a necessity. Market forces are
• Voters believe everyone should have access
to quality, affordable health care — but don’t
want to pay for ―undeserving‖.
• Voters want an “American” solution.
Skeptical of ―government run,‖ but role as a
• Cynicism about government
• Concerns about government bureaucracy, red
tape, high costs
• Who pays for it?
• Fear of higher costs, higher taxes
• Scarcity – voters worry about what they will lose
• Illegal immigrants and other “undeserving”
• Perceived impact on small businesses
• The ability of powerful interests to block action
Dealing with Barriers
• Incorporate “ personal responsibility”
• Include options and choices in proposals – make
sure it’s employee choice, not just employer
• Use preventive care as a stepping stone
• Find a uniquely American solution, including
• Emphasize security and peace of mind Focus on
support for small business
• Define a role for government as watchdog and
• Animate anger, not fear
Not Universal coverage But Quality affordable health care
Not A system like Social Security; Canadian Style Health
Care But American health care
Not Medicare for All But a choice of public and private
Not Free But Sliding scale
Not Wellness But Prevention
Not Inexpensive But Smart investments;
investing in the future
Not Competition But Choice
Dealing with Barriers:
When we pass Clean Air
Legislation, build roads, or
open new schools it’s for
everyone in our community
Immigration is a federal issue Only 6% of the uninsured
population are immigrants
workers actually improves 85% of the uninsured are people
California’s rates who don’t get health coverage
from their employer
Public Health Risk
Only $11 per household per year
Providing preventative care is is spent on taxes to cover care to
less expensive than treating undocumented workers
someone who is very ill
The masses will move to California
because we have healthcare
SB 840 requires residency
California was the first
state in our nation to pass
Will the masses move
here from other states?
(think about it!)
Tactics used to scare us 29
Doctors will leave
Earnings roughly twice as
Doctors spend years in much as elsewhere –
school incomes 6. 6 times
greater than the average
Important jobs patient
Anesthesiologists $58 billion in excess
$425,000 income after loans are
Specialists $274,000 paid off
$8 billion as investors in
General Practitioners diagnostic labs and
$173,000 outpatient surgical clinics
Tactics to Scare Us! 30
California’s tax payers paid $32 million
dollars in uncompensated care for Wal-
Mart in 2005
Shared responsibility – Government,
Employers and Individuals
Should a small business have to pay
what McDonalds or Wal-Mart pays?
Senator Kuehl wants small business at
It’s American for everyone to pay their fair share 31
Howard Schultz (Mr. Starbucks)
Every American should have healthcare
No one should have to pay more than 10%
of their income
Business should be insulated from excess
health inflation to remain competitive
What does single payer save
Eureka City Schools – $1.5 to $2.6 million
Salinas UHSD -$4 to $6.5 million
Stockton USD- $9.9 to $17 million
San Diego USD- $15 to $41 million
Elk Grove USD- $2 to $12 million
LAUSD- $127 to $279 million
Long Beach Combined Employer and Employee
Savings of $22 million
Visalia USD- $8.7 to $12.8 million
Use payroll tax rates suggested by the Lewin
Report, 8.17% for employers, 3.78% for
employers, for a combined 11.95%
What do we need from you?
Talk about this with your
Get the stories of those who are
struggling (human tragedy)
Fill out the cost calculation
Participate in Campaigns
Will it work again?
"Harry and Louise," 1993
Why have incremental reforms proven
so ineffective in practice?
“You Can’t Cross a Chasm in Small
Steps” – David Lloyd George
Something to Ponder…
We have a publicly financed military to
We have publicly financed police and
fire to keep us safe
We have publicly financed education to
provide education to all children
Why don’t we have publicly financed
health care to provide health care to all?
Can We Do It?
Gray Panthers Still Supports California’s
SB 840, Single-Payer Healthcare!
Security Choice Comprehensive
Benefits hospital, medical, surgical,
mental health; dental and vision care;
prescription drugs and medical
equipments, diagnostic testing, hospice
care and more.
Fair Reimbursement & Cost Controls
Maggie Kuehn’s vision
Maggie supported single-payer in
and Gray Panthers have never wavered
Federal Congress people
Find your Congressperson:
Boxer, Barbara- (D - CA) 112 Hart
Senate Office Building, Washington http://www.house.gov/Welcome.shtml
Feinstein, Dianne- (D - CA) 331 Hart
Senate Office Building, Washington
Where to Go For Help/Info
Health Insurance Counseling and Advocacy Program
(HICAP): Call 1-800-434-0222 to reach your local
HICAP or go to www.calmedicare.org
National Committee to Preserve Social Security and
Medicare: http://www.ncpssm.org/medicare/ (a
national, nonprofit organization)
Social Security: 1-800-772-1213 or go to
Center for Medicare and Medicaid Services (CMS):
Call 1-800-MEDICARE or go to www.medicare.gov
Low income subsidy: go to
www.ssa.gov/prescriptionhelp or call 1-800-772-1213
Together, we can fix this mess!
―Guaranteed affordable health insurance
coverage for every American with a choice
of private or public plans that cover all
necessary medical services, paid for by payroll
taxes on employers and individuals on a
sliding scale. ―
…Only fear can stop us!