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SWWAP.ORG
Health Care For All!
Thanks to Dr Jerry Sielaff for providing this
Basic background info needed to participate in the “Debate”
- US Population 300 million
- Uninsured 46 million
What does it all cost? (Nation Health Expenditure - NHE)
~ 1960 = $26.5 billion ($148/capita, 5.2% GDP)
~ 2008 = $2.4 trillion ($8,000/capita, 16.9% GDP)
~ 2020 = $4.3 trillion (12,000/capita, 20.3% GDP
Who pays what? – Tax payers 60%, employers 20%, individuals 20%
- How does the average family of 4 pay their annual cost of $16,771
~ employer premium - $9,947, employee premium $4,004
~ employee out-of-pocket costs - $2,820
How much can people afford?
~ median 2007 household income for family of 4 - $50,233, WI - $42,000
~ federal 2009 poverty levels – family of 4 = $22,200 and adult $11,200
What would the “IDEAL” system of health care delivery include?
- affordable access to the doctor, clinic, and hospital of your choice
- affordable medications
- affordable mental health care
- affordable home care
- affordable long term care
- no change in the above when you change/lose your job or move
- no arbitrary yearly or lifetime limits on the care you need
So what is SINGLE PAYOR HEALTH CARE?
- Just what we described above for an IDEAL system – That is access to the
doctor, clinics and hospitals of our choice….
- FOR ALL 300 MILLION OF US!
- Paid for by a SINGLE PAYOR!
- The SINGLE PAYOR plan would replace all of our currently fragmented coverage from Medicare, Medicaid, SCHIP, the VA, and private health insurance companies.
What does this cost and who pays for it?
- We can cover all 300 million of us for the same $2.4 trillion we spend now
- We all pay in up front through a SIMPLE, FAIR, PROGRESSIVE TAX
- This way everyone pays in based on their ability to do so, no complex rules
- There would be no more DEDUCTIBLES, CO-PAYS, CO-INSURANCE
- More importantly, there will be a fighting chance of containing or slowing the exploding cost of health care (6.2% per year!) through the bargaining power of the SINGLE PAYOR with pharmaceutical companies, etc.
But what about CHOICE?
- You choose your doctor, your clinic, your hospital, your pharmacy
- Physicians and other providers continue to practice just as they do now but with more time for patients and less time spent filing claims
- The only difference is they all submit their bills to THE SINGLE PAYOR!
But what happens to all the privately owned and operated hospitals, and insurance companies?
- Hospitals remain non-profit institutions just as they are now and receive a global budget each year from the SINGLE PAYOR
- While no insurance company can offer policies that cover the same benefits as the single payor plan, they can and will sell supplimental policies just like they do in every other single payor country in the world and just like AFLAC and Medi-gap companies do now.
Why is SINGLE PAYOR better than just using tax dollars to help us buy private Health insurance Insurance?
FIRST - it covers all 300 million of us, no exceptions
SECOND – everyone pays in upfront based on their ability to do so and receives the same benefits as everyone else
THIRD - your coverage does not change based on employment, income, age, where you live, or whether you have a serious illness
FOURTH – doctors can get back to treating patients and stop worrying about who’s covered and who’s not because EVERYONE IS COVERED!
FIFTH – the SINGLE PAYOR can negotiate with drug companies instead of each of us trying to buy our meds in Canada,,
FINALLY – WE will decide how much gets spent on healthcare and what gets covered for everyone. No more rationing based on ability to pay!
DELAYS in Canada:
- Talking points of conservative media – a 64y/o man would be denied chemo/surgery for cancer and told to wait 10-14 months before being seen. If you try to pay for more care yourself you would go to jail for a year plus a $50,000 fine….
ACTUALLY, according to Statistics Canada (similar to our US Census)
- Median wait time for elective surgery across Canada – 4 WEEKS
- Median wait time for diagnostic imaging like MRI’s – 3 WEEKS
- Medical bankruptcy rate in Canada – effectively ZERO
- Whereas Percentage of bankruptcies in US related to health care costs – 62%!
SUPPORT FOR SINGLE PAYER:
- 60-80% of Canadians whenever polled
- 60% of U,S, physicians – Annals of Internal Medicine April 2008
- 49% of Americans (vs 47% opposed) – Kaiser Family Foundation April 2009
- Taiwan studied systems all over the world and modeled their new program covering all of their citizens on US Medicare – April 2009
Problems with public option:
- By simply being another insurance plan, it forgoes 84% of the potential savings of a single payor plan ( administrative costs like cost tracking and billing apparatus) So if 95% of the already insured Americans joined this plan, it would save only $64 billion instead of the $400 billion dollar savings in administrative cost savings possible with single payor
- 25 years of experience with public/private competition in Medicare shows that private plans will not allow a level playing field, but instead successfully cherry pick healthier subjects into private plans and “dump” sicker patients into the public plan
- A public plan does not lead toward single payor, but to segregation of patients, with profitable ones in the private plans and unprofitable ones in the public plan
- Who chooses public option – those who can’t get private insurance or those who can’t afford it. So people with high health costs and not much money
- It can only work if the 3 R’s are followed – Rules, Risk Adjustment and Regional pricing
- Because it is so opposed by AHIP, Pharma, AMA … congress will either so weaken the plan that it won’t work (Schumer’s compromise) or give it away during mark-up to “buy” support from Republicans and conservative dems on other less controversial issues.
- Schumer’s compromise – funded only by premiums and co-pays, no use of the existing medicare infrastructure, no mandating of medicare participating physicians, fees paid must be higher than medicare rates
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