Welcome to a Fireside Chat on Single Payer Healthcare

How do I put this information into a context that I can explain to others?

Can we agree on a set of universal principles? Everyone should be

treated by a doctor if they are ill

Medical care should be returned to the hands of doctors, not insurance company bean counters

No one should profit from people’s suffering

Can we agree on a set of universal principles? Pricing for hospitals and

doctors should not be a secret We should not be herded to a

“panel” of physicians because an insurance company has a financial incentive to do so

No one should pay more than 10% of their income on healthcare

If we continue to allow insurance companies to underwrite health insurance, they will “cherry pick” good risk (those of us who are sick are called “Medical Losses”)

Percent of Firms Offering Health Benefits Declined Over 2000–2005

Source: Kaiser Family Foundation, Employer Health Benefits 2005 Annual Survey.

Percent of firms offering health benefits

606366666869

0

25

50

75

2000 2001 2002 2003 2004 2005

2005 47 Million Uninsured Americans

Number of uninsured, in millions

Projected

2013

Note: Projected estimates for 2004–2013 are for nonelderly uninsured based on T. Gilmer and R. Kronick, “It’s the Premiums, Stupid: Projections of the Uninsured Through 2013,” Health Affairs Web Exclusive, April 5, 2005.Source: U.S. Census Bureau, March CPS Surveys 1988 to 2005.

31 33 33 35 3539 40 40 41 42

43 4440 40 41

44

56

45

0

20

40

60

1987 1987 1993 1996 1999 2002 2005 2008 2011

Per Capita Spending on Health Care – 2004

(How Does GM Compete In A Global Market?)

SSource: Organization for Economic Co-Operation and Development (OECD) Health Data 2006(in U.S. dollars adjusted for purchasing power parity)

$6,102

$4,077 $3,966$3,165 $3,159 $3,041

$2,825$2,249$2,546

$0$1,000$2,000$3,000$4,000$5,000$6,000$7,000

U.S.

Switz

Nor

way

Cana

da

Germ

any

Net

her

Swed

enU.K

.

Japa

n

Train the Trainers Day 1

Source: KFF/HRET Survey of Employer-Sponsored Health Benefits: 2005Note: 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).

12.0

18.0

0.8

13.9^

12.9*10.9*

8.2*

5.3*

11.2*

8.5 9.2*

0

5

10

15

20 Health Insurance PremiumsWorkers EarningsOverall Inflation

Increases in Health Insurance Premiums Compared to Other Indicators, 1988–2005

Percent

Compensation Kings Jay Gellert – Health Net,

$11,639,834 William McQuire – United Health

Group, $10,697,442 Larry Glasscok, Wellpoint (Blue

Cross) $8,523,139 Edward Harnway, Cigna,

$12,373,300 Insurance Company profits

increased 234% from 2000 to 2004

Modern Healthcare: April and July Issues

2006

When did other countries implement universal healthcare?

Germany 1883 Switzerland 1911 New Zealand 1938 Belgium 1945 United Kingdom1946 Sweden 1947 Greece 1961 Japan 1961

Canada 1966 Denmark 1973 Australia 1974 Italy 1978 Portugal 1979 Spain 1986 South Africa 1996 Thailand 2006

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 completely ignore.”

George Carlin

I have a good health plan now How’s your current health

plan working for you?

How has it impacted salary?

Who in your Chapter is hit the hardest?

Health care rates have gone up 87% over the last five years

A family of 4 will cost $23,000 at an 8% inflation or $27,000 at a 10% inflation

Can you bargain this amount of money?

If nothing is done, will only the rich be able to afford health care?

GROWTH IN HEALTH INSURANCE PREMIUM RELATIVE TO WAGE BASE, 2004 - 2014

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$35,000

$40,000

$45,000

2004 '05 '06 '07 '08 '09 '10 '11 '12 '13 2014

WAGE BASE PREMIUM @ 8% GROWTH PREMIUM @ 10% GROWTH

Health Care For All 840 is a policy bill:

Allows us to talk about single payer

Allows us to build public support

Allows us to educate our communities before the insurance companies start attacking (remember Harry and Louise)

Immigrants When we pass Clean Air

Legislation, build roads, or open new schools it’s for everyone in our community

Immigration is a federal issue

Covering undocumented workers actually improves California’s rates

Public Health Risk

Providing preventative care is less expensive than treating someone who is very ill

Only 6% of the uninsured population are immigrants

85% of the uninsured are people who don’t get health coverage from their employer

Only $11 per household per year is spent on taxes to cover care to undocumented workers

Ultimately, you will decide

The masses will move to Californiabecause we have healthcare SB 840 requires

residency

California was the first state in our nation to pass Social Security

Will the masses move here from other states? (think about it!)

Tactics used to scare usTactics used to scare us

Doctors will leave

Student loans Doctors spend years in

school Important jobs Anesthesiologists $425,000 Specialists $274,000 General Practitioners

$173,000

Earnings roughly twice as much as elsewhere –incomes 6. 6 times greater than the average patient

$58 billion in excess income after loans are paid off

$8 billion as investors in diagnostic labs and outpatient surgical clinics

Tactics to Scare Us!

Retirees – SB 840

Early Retirees: If the CBA calls for the

employer to provide health care after you retire, the payroll premium get paid to the health trust (just like an insurance premium)

Medicare Retirees Under SB 840 you

will be covered just as you are now (Medicare $$$ come into the State)

Small business?

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 the table

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

It’s American for everyone to pay their fair shareIt’s American for everyone to pay their fair share

What does single payer save schools? 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

Colton- USD $2.7 to $6.6 million

Capistrano- $2.5 million to $10.9 million

Visalia USD- $8.7 to $12.8 million

Assumptions Use payroll tax rates suggested by the Lewin Report, 8.17% for employers, 3.78% for employers, for a combined 11.95%

Cornerstones Of Our Democracy

1848 – First Women’s Rights Convention held in Seneca Falls, New York – 1972 The Equal Rights Amendment is passed by Congress

1831 Nat Turner leads a slave revolt in Virginia – 1964 Civil Rights Act is enacted

Late 1940s – 50s Congress debates Medicare – Signed into law July 30, 1965

20?? – The great nation of America provides health insurance to all

What will it take to win?Everybody in one risk pool! Doctors Hospitals Providers Business Voters need to provide

politicians a safe haven so they can do the right thing

JMTs JPAs CalPERS Health Plan Building Trades Unions Public employee unions

and employers

YOU and your family and friends!

What do we need from you?

Talk about this with your community

Get the stories of those who are struggling (human tragedy)

Fill out the cost calculation

Pass Resolutions Recruit volunteers Participate in 365

Campaigns

"Harry and Louise" was the name of a television commercial funded by the Health Insurance Association of America (HIAA), a health insurance industry lobbying group, in opposition to President Bill Clinton's proposed health care plan in 1993. The ad depicted a middle-class couple, portrayed by actors Harry Johnson and Louise Claire Clark, despairing over the allegedly bureaucratic nature of the plan and urged viewers to contact their representatives in Congress. It was widely credited as being a major factor in the plan's ultimate defeat, and is often cited as a landmark moment in the use of public relations techniques for lobbying.

Democrats lost the House in 2004

Massachusetts Health Care Reform

Chapter 58 Signed Into Law on April 12, 2006

Both State Houses Were Democrats

Personal Responsibility

Expanded Public

Coverage

Sources: Federal & State Insurance Week 4/12/93; and PR Newswire 11/19/93.

“TennCare will cover an additional 300,000 currently uninsured in the first year. The number of uninsured enrolled in the program could reach 500,000 in

the second year.”

“Tennessee Gov. Ned McWherter unveiled… ‘the most radical health care plan in America’ and claimed

it would become the national model. The Tennessee plan would

gather nearly 1 million current Medicaid patients with 500,000 uninsured Tennesseans into a single managed care program

called TennCare.”

Tennessee 1992

Gov. Ned McWherter

EXPECTATION

% of Uninsured in Tennessee 1987 - 2005

16.6% 15.5% 16.3%

TennCare

REALITY

TennCare Outcomes

TennCare covered up to 400% of poverty line; had $2 in matching federal funds for every $1 spent; TennCare has added over 400,000 new people to the state program, and by 2005 1 of every 4 residents were on Medicaid.

In its first year, percentage of uninsured plummeted from 14.7% to 11.2% of population. But rose to 16.4% the very next year. In 2005, 16.3% of population was uninsured.

Collapse of the TennCare system is imminent. Under Democratic Governor, TennCare’s annual report for 2004-2005 states:

“2004 represented the year the state could no longer ignore the impending fiscal crisis that TennCare threatened if left unchecked.

If left unchecked, TennCare would consume 91 percent of all new revenue growth by 2008, essentially eliminating the state’s ability to fund other state departments and priorities.”

Why AB 8 Won’t Work

Does not actually require the employer to purchase health insurance

Provides for HSAs No cost containment

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 protect us

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?

“First they ignore you. Then they laugh at you. Then they fight you. Then you win”!“Gandhi”

Questions