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HEALTH CARE FOR ALL=

THE PROBLEM OF THE
UNINSURED

Uninsured Americans=

Who are the uninsur= ed?

Lack of Insurance Increases Mortality

Slide 6

Medical Bankruptcy = in Indiana

A Brief History=

Red Baiting=

A Brief History (continued)

Anthem (formerly Bl= ue Cross)
Now Wellpoint

Where Does the Mone= y Come From?

Slide 13

US Versus Other Cou= ntries


And Where Does It Go?

Growth of Physician= s, RNs & Administrators 1970-1998

 What Do Administrators Do?  Cost Shifting.

What Are We Paying = for?

U.S. Overhead Spend= ing

U.S. Overhead Spend= ing

Health Care Administration   
US and Canada

Slide 22

…. And Graft

Columbia/HCA

And What Do We Get
 For All Our Money?<= /p>

Life Expectancy=

Infant Mortality pe= r 1000 Births

WHO Global Health Rankings

Satisfaction with H= ealth Systems in Ten Nations

How Can We Pay So M= uch and Get So Little?

Inpatient Days per = Capita

Slide 32

Slide 33

 % Finding Difficulty in Receiving Care

Elderly as Percent = of Total Population,
 2000

Tobacco Smokers=

MRI Units per Milli= on People

Renal Transplants

The Health Care Sys= tem Dinosaur Stumbles Toward the Tar Pit

Slide 40

Myths

And the Myth of “Mo= ral Hazard”

Myth Versus Realty<= /a>

Slide 44

Slide 45

The Health Care We = Get

The Health Care We = Want

We Have What it Tak= es

Government Health Insurance for All, Even if Taxes Increase?

Please indicate whe= ther you support or oppose this policy:  Universal Health Insurance

Remember  Columbia/HCA?

Why Health Care for
Every Person,
Young or Old,
Rich or Poor?

"“The care of = human..."

Slide 54

"“Never doubt = that a..."

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

WHAT ABOUT MALPRACT= ICE?

WHAT ABOUT MALPRACT= ICE?

WHAT ABOUT MALPRACT= ICE?

Slide 66

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HEALTH CARE FOR ALL=
Myths and Reality

THE PROBLEM OF THE
UNINSURED
46 Million is 16% o= f the population.
Indiana has 800,000= uninsured
To get 46 million t= ake all of Indiana, plus Texas, Florida, and Connecticut.

Uninsured Americans=

Who are the uninsur= ed?

Lack of Insurance Increases Mortality
18,000 excess death= s per year due to lack of health coverage
People without insu= rance: - Receive less care and receive it later - Have 25% higher mortality rates - Receive poorer care when they are in   hospitals
This is the fifth l= eading cause of death in the US
The safety net is f= ull of holes

Slide 6

Medical Bankruptcy = in Indiana
2004 estimate: 55,0= 00 bankruptcies
Almost 28,000 relat= ed to medical costs
Affecting 77,000 fa= mily members
75% had coverage at= start of illness
Average out of pock= et medical expenses leading to bankruptcy - almost $12,000.

A Brief History=
Wage and price cont= rols in WW II
Truman pushes for N= ational Health Insurance 1949.  AMA oppos= es.

Red Baiting=
“Would socialized m= edicine       lead to socialization of other p= hases of life?  Lenin thought   so.  He declared socialized medicine is the keystone to       the arch of the socialist state.= ”

A Brief History (continued)
The birth of the Bl= ues
The Great Society:<= span style=3D'mso-spacerun:yes'>  Medicare and Medicaid 1965
The Clinton Health = Plan 1993
The death of the no= t-for-profit Blues

Anthem (formerly Bl= ue Cross)
Now Wellpoint
CEO Larry Glassock = is in Indianapolis
The highest paid ex= ecutive in Indiana
Bonus announced in = 2003 was $42.5 Million

Where Does the Mone= y Come From?
          And Where Does It Go?<= /td>

Slide 13

US Versus Other Cou= ntries


And Where Does It Go?
The money is going = to:
- Overhead<= /td>
- Inefficiency
- Waste
- Profit
- And graft=

Growth of Physician= s, RNs & Administrators 1970-1998

 What Do Administrators Do?  Cost Shifting.
The $5 aspirin pill=
The $500 ER bill
“Skimming the cream= off the top”: Avoiding the costly, the very sick, and the uninsured

What Are We Paying = for?
A Very Complex Syst= em
7000+ private healt= h plans
An army of people t= o deny health insurance coverage and payments
And an army of peop= le to try to maximize and receive health insurance payments
An army of people t= o determine who is eligible for what program

U.S. Overhead Spend= ing

U.S. Overhead Spend= ing

Health Care Administration   
US and Canada
US administrative s= pending =3D $399.4 Billion or 31% of total health care costs.
Canada spends 17% on administrative overhead.
Potential savings = =3D $286 Billion, enough to cover the uninsured and then some.

Slide 22

…. And Graft
“Investor ownership= has been shown to compromise quality of care in hospitals, nursing homes, dialysis facilities, and HMO’s; for-profit hospitals are particularly costly.  A wide array of investor-owned firms = have defrauded Medicare and been implicated in other illegal activities.”

Columbia/HCA
Fined $1.7 Billion = in 2003 for Medicare fraud, the largest fine in Medicare history.
No one went to jail= .
CEO Richard Scott l= eft with a $10 million severance package and over $300 million in stock.

And What Do We Get
 For All Our Money?
The most expensive = health care in the world, no doubt.
The best health car= e in the world?
How would you measu= re the best health care in the world?

Life Expectancy=

Infant Mortality pe= r 1000 Births

WHO Global Health Rankings
Based on outcomes A= ND fair                distribution of care
At the top:  #1. France,  #2. Italy
US ranks 37th, betw= een Costa Rica and Slovenia

Satisfaction with H= ealth Systems in Ten Nations
Harris Poll taken i= n US, Canada, UK, Germany, Australia, France, Sweden, Japan, Italy, and Holland= .
The U.S.  had the lowest health care satisfacti= on rate (11 percent) of the 10 nations.

How Can We Pay So Mu= ch and Get So Little?

Inpatient Days per = Capita

Slide 32

Slide 33

 % Finding Difficulty in Receiving Care

Elderly as Percent = of Total Population,
 2000

Tobacco Smokers=

MRI Units per Milli= on People

Renal Transplants

The Health Care Sys= tem Dinosaur Stumbles Toward the Tar Pit

Slide 40

Myths
Our “system” is fin= e, it just                     needs ad= justment
There is a safety n= et
We can’t afford to = cover                   everyone
We have the best he= alth care system in the world

And the Myth of “Mo= ral Hazard”
“If you think healt= h care is expensive now, just wait until it’s free.” PJ O’Roarke
The “logic” of Heal= th Savings Accounts
The 80/20 rule
Some things are bes= t not left to the marketplace

Myth Versus Realty<= /a>
Every other industr= ialized country has come to the same conclusion, a national program to insure hea= lth care for all.
We can learn from t= he Canadian experience:
National health in= surance (a “single payer”)         Fee for s= ervice independent doctors just like our  Medicare                                               =               Not-for-profit independent hospitals

Slide 44

Slide 45

The Health Care We = Get
1/3 are uninsured or underinsured
HMOs deny care to m= illions more with expensive illnesses
Death rates higher = than other wealthy nations’
Costs double Canada= 's, Germany's, or Sweden's - and rising faster
Executives and inve= stors making billions
Destruction of the doctor/patient relationship

The Health Care We = Want
Guaranteed access
Free choice of doct= or
High quality=
Affordability
Trust and respect

We Have What it Tak= es
Excellent hospitals= , empty beds
Enough well-trained professionals
Superb research
Current spending is= sufficient
Polls show the peop= le are ready for change
Large and small bus= iness are calling for change

Government Health Insurance for All, Even if Taxes Increase?

Please indicate whe= ther you support or oppose this policy:  Universal Health Insurance

Remember  Columbia/HCA?
Senate Majority Lea= der Dr. Bill Frist owns $25 million in HCA stock.
HCA is the Frist fa= mily business.

Why Health Care for
Every Person,
Young or Old,
Rich or Poor?

"“The care of = human..."
“The care of human = life and happiness, and not their destruction, is the first and only legitimate ob= ject of good government.”
Thomas Jefferson

Slide 54

"“Never doubt = that a..."
“Never doubt that a= small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. “
Margaret Mead

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

WHAT ABOUT MALPRACT= ICE?
Democrats propose l= imiting “frivolous suits” thru something like the panels we have here in Indiana.  Good idea.
Republicans favor p= utting caps on non-medical settlements like we have here in Indiana.  Good idea.

WHAT ABOUT MALPRACT= ICE?
Future medical paym= ents themselves are about 25% of total payouts.
Many suits are trig= gered by anger over bills for care received.
Both of these facto= rs would be taken care of by a single payer system.

WHAT ABOUT MALPRACT= ICE?
Malpractice costs a= ccount for ~1% of total health care spending.
The real answer is = for doctors and lawyers to come together and face their common enemy: the insurance industry.

Slide 66

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