THE HEALTH CARE SOLUTION FOR BUSINESSES Developed by The California OneCare Campaign, a project of HealthCare for All California. With images contributed by Deborah Richter, M.D. www.californiaonecare.org www.californiaonecare.org www.california OneCare.org 888.442.4255 www.healthcareforall.org
The Health Care Solution for Businesses 2 of 15 CONTENTS Introduction 3 I. The Problem 4 II. Comparisons 7 III. The Financing Disaster 9 IV. A Single Payer System 10 V. SB 810 and Benefits for Businesses 11 VI. Affordability 13 VII. Total Costs 14 VIII. What Can Business Owners Do? 15
The Health Care Solution for Businesses 3 of 15 THE HEALTH CARE SOLUTION FOR BUSINESSES BUSINESS OWNERS WANT TO DO THE RIGHT THING FOR THEIR EMPLOYEES Business owners want to reward employee commitment and discourage turnover through a good health insurance program. However, with health insurance premiums escalating at an unsustainable rate, small and medium-sized businesses face a terrible choice for their employees: cut back on insurance coverage, eliminate it entirely, or offer diminishing salary packages. Today s typical plan is becoming more costly every year and prohibitive for many. As employers get less and less for their investment each year, they desperately need to change the way they manage this rampaging insurance gorilla. THIS CERTAINLY WILL REQUIRE A NEW WAY OF THINKING ABOUT HOW WE PAY FOR HEALTH CARE The contents of this package will help small and medium-sized businesses deal with the rampaging gorilla in their midst: rapidly increasing healthcare insurance costs. It includes key data from a physician s outreach program for businesses, information about present California legislation that would provide a comprehensive solution, cost savings, and what business owners can do. For important additional information, please visit our websites, www.california OneCare.org and www.healthcareforall.org.
The Health Care Solution for Businesses 4 of 15 I. THE PROBLEM Judith Glass Comment: On p.2 put U.S.. first and use different font to highlight. WE PAY HIGH TAXES FOR HEALTH CARE Americans Pay World s Highest Taxes for Health Care Per Capita Health Spending, 2002 $6,000 $5,000 $4,000 Public Expenditures Private Expenditures $3,000 $2,000 $1,000 $0 U K Sweden Ger many Canada Norway U.S. OECD and Paying for National Health Insurance And Not Getting It Health Affairs: July / August 2003 INSURANCE PREMIUMS ARE GOING UP 70 Health Insurance Premiums are Rising More Rapidly than Inflation or Workers Earnings 60 50 40 30 20 10 Health insurance premiums O verall Inflation W orkers Earnings 0 2000 2001 2002 2003 2004 2005 Source:Employer Health Benefits 2005 Annual Survey
The Health Care Solution for Businesses 5 of 15 BUT, DO WE GET THE WORLD S BEST HEALTH CARE? NO! Comparison of Quality of Care Survival Rates for Five Countries U.S. Canada England N.Z. Australia Breast Cancer 4th Colorectal Cancer 4th Cervical Cancer 4th Childhood Leukemia 4th Kidney Transplant Liver Transplant * Non-Hodgkin s Lymphoma 4th AMI, ages 20-84 NA NA Stroke, ages 20-84 NA NA Life Expectancy, 2002 80 79.5 79 78.5 78 77.5 77 76.5 76 75.5 79.7 79.9 79.9 79.4 78.5 78.1 77.1 U.S.* U.K.* Germany* France Canada* Italy Sweden OECD 2004 - * Figures are for 2001
The Health Care Solution for Businesses 6 of 15 More Babies Die in the US in the First Year of Life 7 6.9 6 5 4 3 5.3 4.7 4.1 4.1 3.9 3.1 2 1 0 U.S. Canada Australia Italy Germany France Sweden
The Health Care Solution for Businesses 7 of 15 II. COMPARISONS WHAT ABOUT OTHER INDUSTRIALIZED NATIONS? Other Industrialized Nations Have similar demographics Have availability of expensive technology Have rising drug costs Have similar levels of services OTHER COUNTRIES KNOW HOW TO SAVE ON HEALTH CARE Why are Costs Lower in other Countries? Administrative simplicity Lower prices Higher ratio of primary care providers to specialists Health planning Sensible budgeting
The Health Care Solution for Businesses 8 of 15 CANADIANS ENJOY LOWER COST UNIVERSAL COVERAGE AND IT S A MYTH THAT THEY TYPICALLY TRY TO SEEK CARE HERE! Few Canadians Seek Care in the U.S. Survey of U.S. Ambulatory Providers Near the Border, Hospital Discharges, and Canadian Citizens 40% of U.S. ambulatory facilities near the border treated no Canadians last year; another 40% treated fewer than one per month. Michigan + New York + Washington hospitals treated a total of 909 Canadians per year (only 17% of them elective.) Of America s Hospitals only one reported treating more than 60 Canadians per year. In a survey of 18,000 Canadians, 90 had received any medical care in the U.S. last year only 20 had gone to the U.S. seeking care. Source: Health Affairs 2002;21(3):19 HOW CAN WE IMPROVE HEALTH CARE QUALITY, COVER THE UNINSURED, AND MODERATE UNNECESSARY COST INCREASES?
The Health Care Solution for Businesses 9 of 15 III. THE FINANCING DISASTER OUR CURRENT FINANCING SYSTEM IS A DISASTER! What Are Our Current Financing Problems? Our existing health care system does not assure that every patient has coverage Financing of our health care is not stable The financing of health care is really a shell game with all the payers trying to avoid paying the fixed costs of health care When that fails we ask the public to step in (risk shift) PART OF THE PROBLEM IS THE HUGE GROWTH OF ADMINISTRATIVE SERVICES CALIFORNIA HAS OVER 600 HEALTH INSURANCE POLICIES. A SIGNIFICANT PORTION OF PREMIUMS GOES TO ADMINISTRATIVE OVERHEAD.
The Health Care Solution for Businesses 10 of 15 IV. A SINGLE PAYER SYSTEM WHY DON T WE GET SMART AND CREATE A SENSIBLE SINGLE PAYER SYSTEM? Single Payer Health Care System Sweden, Norway, Denmark, Canada, Finland, Iceland, Australia, and Taiwan all have single payer financing Single risk pool that pays for health care directly from a fund earmarked for health care Everyone has access to privately delivered health care services Anyone can choose to buy health insurance for services not covered by public plan. Fundamental Features of a Universal Health Care System Everyone included Public financing Sensible budgeting process Public accountability Public stewardship
The Health Care Solution for Businesses 11 of 15 V. SB 810 AND BENEFITS FOR BUSINESSES CONSIDER THIS CALIFORNIA UNIVERSAL INSURANCE LEGISLATION! The California Universal Healthcare Act (Senate Bill 810) establishes a California Health Insurance Agency administered by a Health Insurance Commissioner and advisory boards. The public agency will replace most health insurance plans in California by providing comprehensive health insurance to all residents. Health care providers, including doctors, hospitals, HMOs, and clinics, will remain private, but will receive payment from this public single payer plan, instead of from Medicare, Medi-Cal, Healthy Families, county governments, or one of thousands of private insurance plans currently serving Californians. SB 810 has three major advantages over the current situation: All residents will be covered, the coverage is better than almost any existing insurance, and it will cost less than what we are now paying. Savings will come mainly from a reduction of the administrative overhead, which is over 25% in California today. HOW SB 810 WILL BE BENEFICIAL TO BUSINESSES Health premiums will cost less than businesses now pay for comprehensive employee health care. Proposed health care taxes are 8.17% on employers and 3.78% on employees, or a total of $5,975 for an employee earning $50,000 per year. This compares to $7,500 to $12,000 typically paid for good health insurance, depending on the size of the business. Donna Benedetti 4/1/08 11:14 PM Comment: Health premiums will be proportional to payroll, not to the number of employees. Businesses with many lower-wage employees will see affordable health care costs. Currently, these kinds of businesses find health care insurance costs to be prohibitive.
The Health Care Solution for Businesses 12 of 15 Businesses will save considerable money by not administering health insurance. Temporary and part-time workers will be covered the same as others. The complications of covering these workers will disappear. It will be easier to upgrade workers to full-time. The contentious health insurance issue will be removed from labor contract negotiations.
The Health Care Solution for Businesses 13 of 15 VI. AFFORDABILITY HOW CAN WE AFFORD A SINGLE PAYER SYSTEM? A 2005 Lewin Group report shows that California in 2006 would have saved money by adopting a single payer system (SB 810). The following savings would have been realized: Lower insurer administration, by about 69% saves $9.686 billion Lower physician administration, by about 30% saves $6.614 billion Lower hospital administration, by about 22% saves $3.56 billion Bulk purchasing of prescription drugs saves $4.418 billion Bulk purchasing of medical equipment saves $786 million Increased primary care saves $3.408 billion Less fraud saves $783 million
The Health Care Solution for Businesses 14 of 15 VII. TOTAL COSTS BUSINESSES MUST RECOGNIZE THEIR DIRECT COSTS OF PROVIDING PRIVATE HEALTH INSURANCE! For small/moderate-sized businesses, current total costs for private health insurance premiums average 13-15% of payroll. Premiums have increased 75% since 2000, averaging over 10% per year. Under a Single Payer Plan, these costs would be cut by about 35%, to approximately 8%! Administrative costs being eliminated by a Single Payer Plan would include getting quotations, evaluating coverage options, upgrading payroll deduction files, processing monthly carrier payments, and resolving employee coverage disputes with the carriers.* *A detailed Cost Comparison Worksheet is available on our website, www.california OneCare.org.
The Health Care Solution for Businesses 15 of 15 VIII. WHAT CAN BUSINESS OWNERS DO? LEGISLATORS LISTEN TO BUSINESS OWNERS. YOU ARE KEY TO PASSING SINGLE PAYER LEGISLATION. YOU CAN... Sign an endorsement for SB 810 at www.california OneCare.org. Refer your business friends to the California OneCare Campaign for single payer health coverage. Ask your associations, such as the Chamber of Commerce and the Farm Bureau, to endorse SB 810. Visit or contact your legislators and the Governor. Donate to the California OneCare Campaign for single payer at www.california OneCare.org.