will we ever have healthcare for everyone? like in the rest of the civilized world. rob stone md...
TRANSCRIPT
Will We Ever Have Healthcare for Everyone?
Like in the rest of the civilized world.
Rob Stone MDDirector, Hoosiers for a Commonsense Health PlanAssistant Clinical Professor of Medicine, IUSM
DISCLOSURES
Dr. Rob Stone has no relevant financial relationships with commercial interests.
Slides can be downloaded at: HCHP.info/Presentations
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Lack of Insurance Kills
49,000 deaths a year 1 death every 11
minutesPeople without
insurance: Live sicker and die younger The safety net is full of holes
American Journal Public Health, Wilper et al, Dec 2009
Affordable Care Act
Original projection: 30-35 million newly covered
Half thru Health Insurance Exchanges (Mandate)
Half thru Medicaid expansion Supreme Court Decision Summer 2012
US Census Dept, “Income, Poverty, and Health Insurance Coverage” Sept 2012 Himmelstein et al, American Journalof Medicine, August 2009
Health Insecurity Indiana 800,000 to 900,000
Hoosiers uninsured
Hoosier bankruptcy filings because of medical bills:> 27,000 annually
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Hoosier Medicaid Expansion
Estimated 300 – 450 thousand lives covered, ~ half the uninsured
Largest increase in coverage in >50 years
$11 a day versus $30,000 a year
Hoosier Medicaid Expansion
Traditional Medicaid 60/40 Federal/State ACA Medicaid 100% tapering to 90%
Federal Cost to Indiana taxpayers: $50-150 million Federal subsidy: $1.7 billion a year At least $11 return for every $1 invested
A Deal Too Good to Refuse
HIP cigarette taxes - $121 million High risk pool - $48 million Savings from prisons and jails Effects on hospitals Job creation
“I’m afraid we’ll have to remove your wallet.”
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What Are We Paying For?
An incredibly complex system Thousands of plans Armies of people to:
-deny coverage and payments- collect payments- determine eligibility
Efficiency and Overhead
$ 2003, 31% of US health spending on overhead
$ Medicare’s overhead – 3%$ Cover everyone at Medicare rate:
savings = $286 B [400 B in 2011 dollars] 1 $ 1991-93,GAO, CBO: “The net cost of
Single Payer would be negative.”2,3
1New England Journal of Medicine 8/21/20032Congressional Budget Office, 1993, 3 separate reports3General Accounting Office, 06/91 ref: T-HRD-91-35
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What Do We Get For Our Money?
The most expensive health care in the world
The best health care in the world?
WHO Global Health Rankings
☤ At the top: France is #1
☤ US ranks 37th, between Costa Rica and Slovenia
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Why spend so much AND get so little?
Reason # 1: Our profit-driven insurance system
AND As long as millions are
left out, everyone will suffer
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Myths
Our “system” is fine, just needs band-aids
The safety net We can’t afford to cover everyone The best health care system in the world
International Timeline of Universal HealthcareGermany 1883 Switzerland
1911New Zealand 1938
France 1945
United Kingdom 1946
Sweden 1947
USA 1947*
Japan 1961
Canada 1966
Australia 1974
Italy 1978
Spain 1986
Taiwan 1995
*President Truman proposed but failed to pass National Health Insurance
Our Non-System of Illness Care
A Dinosaur Stumbling Toward a Tar Pit
Why Health Care for All -
Young and Old, Rich and Poor?
What Can We Do?
✔ Educate Ourselves✔ Find Our Voices✔ Join In
PNHP.org
