Robert Zarr, MD, MPH, FAAP DC PNHP

Transcription

1 Universal Health Care without Private Health Insurance? Single Payer: The Only Affordable, Lifelong, Comprehensive, Quality Health Care Plan for Every American Robert Zarr, MD, MPH, FAAP DC PNHP

2 MY STORY Sept 22, 2007,at 1pm, I was assaulted Loss of consciousness Ambulance ride & ER visit NO in-network ambulance coverage for my insurance policy? Monthly bills from DC EMS After 5 months, insurance finally paid ONLY 75% of transport cost

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4 Best health care system in the world?

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6 18,314 Adult Deaths Annually Due to Uninsurance

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16 We are the best at spending the most money to be ranked 37 th in health outcomes by WHO!

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20 Government Funds Most Academic Research

21 Insurance Overhead 2001

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23 In summary, private insurance: Is wasteful ($350 billion a year) Reduces the buying power of 300 million American purchasers (decreased monopsony) Reduces transparency of health care system problems and solutions Does not provide lifetime comprehensive quality health care to any American

24 Individual & employer mandates, HSAs, High Deductible Plans, Free Market models = MORE OF THE SAME Insanity: Try it the same way every time and expect different results.

25 READY FOR REAL CHANGE? SINGLE PAYER NATIONAL HEALTH INSURANCE

26 House Resolution 676: United States National Health Insurance Act (Expanded and Improved Medicare for All Act)

27 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. No corporate profit and personal fortune. 4. In a democracy, the public should set overall health policies.

28 Single Payer NHI guarantees: Comprehensive Care Quality Choice Affordability

29 Single payer NHI would cover every American for all lifetime 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

30 Prescription Drugs and Supplies NHI would pay for all medically necessary prescription drugs and medical supplies, based on a national formulary Regional expert panels would establish and regularly update the formulary NHI would provide all Americans with full coverage for necessary drugs and supplies

31 Payment for Physicians and Outpatient Care: 3 Options 1. fee-for-service, or 2. salaried positions in institutions receiving global budgets, or 3. salaried positions within group practices or HMOs receiving capitation payments

32 How Do We Know It Can Be Done? Every other industrialized nation has a healthcare system that assures health care for all All spend less than we do; most spend less than half Most have lower death rates, more accountability, and higher satisfaction No country has ever adopted single payer, found it to be worse, and switched back

33 But, can we afford NHI? We can't afford NOT to have NHI!

34 Projected 2010 Health Care Expenditure Comparison of: Current Health Care System to those of National Health Insurance (NHI, Improved and Expanded Medicare for All, HR 676) Status Quo ($ billions) Spending Federal spending (Medicare, Medicaid, DSH, etc.) Spending State and Local spending Spending Private Insurance spending (premiums) Spending Out of pocket spending (co-pays, deductibles, over the counter drugs, etc.) Spending Other private funds spending (foundations, etc.) Savings Savings from reduced administrative cost (paperwork) Savings Savings from bulk purchase of Rx DRUGS 0 87 Savings Savings from non-durable medical supplies 0 13 Savings Savings from durable medical supplies 0 9 Additional Revenue Additional Revenue Additional Revenue Additional Revenue Additional Revenue NHI ($ billions) Additional Payroll Tax (3.3% increase over current 1.4%) Stock transfer tax (0.25% on seller and buyer) Corporate Welfare Reduction Reversal of 2001 and 2002 Tax Cuts Tax surcharge (5% on highest top 5% earners and 10% on top 1% earners) Total ($billions) 2,776 3,011 Surplus (3,011-2,776)

35 So, is this politically feasible?

36 ,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 PNHP Total Membership Year Members

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38 Broad Support from: 92 US Congressional co-sponsors of HR 676 (more than any other bill) 59% of US physicians 70,000 medical students 75,000 nurses Faith organizations 2 state governments (Kentucky and N.H. House of Representatives) U.S. Conference of Mayors 452 union organizations

39 Robert Zarr, MD, MPH, FAAP