A General Introduction to the Reasons for Single Payer Health Care

Intro
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Reasons for Single Payer Health Care –
A General Introduction

This slide show was created by Physicians for a National Health Program (pnhp.org) and provides an overview to the problems with our current system and how a single payer system can solve these problems.

This version has been converted from a Powerpoint slide show in order to run in a web browser.

If you would like someone from KYHealthCare to give a similar presentation to your organization, please let us know!

Source: pnhp.org
1/18
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Number of Uninsured Americans
1976-2002
Graph: Number of Uninsured Americans from 1976-2002
Source: Himmelstein, Woolhandler, & Carrasquillo – Tabulation from CPS & NHIS Data.
2/18
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18,314 Adult Deaths Annually
Due to Uninsurance

Age Group Deaths
25-34 1,930
35-44 3,431
45-54 4,734
55-64 8,219
   
Total 18,314

Source: Care Without Coverage. Institute of Medicine, 2002.
3/18
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HMO Executives’ Compensation, 2002
Executive Firm Pay New Stock Options
John Rowe Aetna $3.5 mil $5.4 mil
Ronald Williams Aetna $2.3 mil $3.8 mil
Larry Glasscock Anthem $3.3 mil $22.9 mil
Edward Hanway Cigna $1.0 mil $6.4 mil
Jay Gellert Health Net $1.5 mil $11.7 mil
William McGuire United Healthcare $7.2 mil $72.0 mil
Stephen Hemsley United Healthcare $3.3 mil $14.9 mil
Leonard Schaefer Wellpoint $6.9 mil $12.0 mil
4/18
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Profit-Driven Care Begets Fraud
Recent Criminal and Civil Fines/Settlements
  • NME (Tenet) – $683 million: Medicare fraud, patient abuse
  • SmithKline, Cornng, LabCorp – >$800 million: billing fraud
  • Caremark – >$200 million: kickbacks & fraud in home IV business
  • Fresenius/NMC – $486 million: dialysis fraud
  • Roche & BASF – > $725 million: price fixing cartel
  • Beverly – $175 million: Nursing home fraud
  • Noll – $135 million: Suppressing research data on Synthroid
  • Columbia/HCA – $745 million: fraud + continuing investigation
  • TAP Pharmaceuticals – $875 million: criminal kickbacks, Lupron
  • Schering-Plough – $500 million: Shoddy manufacturing
  • Bayer – $275 million: criminal Medicaid fraud
Sources: NYT 7/30/97, 10/10/99, 11/3/99, 1/20/00, 2/4/00,/5/18/02, 4/17/03; Mod Hlthcare 3/25/96, 3/3/97, 10/8/01; Nation 4/7/97; DHHS Insp. Genl.; CBS 60 Minutes 12/19/99
5/18
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Investor-Owned Care
Summary of Evidence
  • Hospitals: Costs 3-11% higher, fewer nurses, higher overhead, death rates 6-7% higher, fraud
  • HMOs: Higher overhead, worse quality, collaboration with tobacco industry
  • Dialysis: Death rates 20% higher, less use of transplants & peritoneal dialysis, fraud
  • Nursing Homes: More citations for poor quality, fraud
  • Rehab Hospitals: Costs 19% higher
6/18
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U.S. Drug Spending
1976-2004
U.S. Drug Spending, 1976-2004

Source: CMS, Office of the Actuary. Note: 2002-2004 estimated.
7/18
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U.S. PUBLIC Spending Per Capita for Health
is Greater Than TOTAL Spending in Other Nations
Healthcare: U.S. public spending outpaces total spending in other countries
Note: Public includes benefit costs for govt. employees & tax subsidy for private insurance.
Source: OECD 2003; Health Aff 2002; 21(4) 99.
8/18
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Infant Mortality, 2000
Deaths in the First Year of Life/1000 Live Births
U.S. infant mortality higher than other developed nations.
Source: OECD, 2003.
9/18
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Life Expectancy, 2000
Life Expectancy - U.S. vs Other Industrialized Nations
* Data are for 1999 (Germany)
Source: OECD, 2003.
10/18
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Overall Administrative Costs
United States & Canada, 2003
Overall Administrative Costs - United States & Canada, 2003
Source: Woolhandler/Himmelstein/Campbell NEJM 2003; 349:768 (updated)
11/18
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Health Costs as % of GDP:
U.S. & Canada, 1960-2010
Health Costs as % of GDP: U.S. & Canada, 1960-2010
Source: Statistics Canada, Canadian Inst. for Health Info., & NCHS/Commerce Dept.
12/18
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The Health Care Americans Get
  • 1/3 are uninsured or underinsured
  • HMOs deny care to millions 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 investors making billions
  • Destruction of the doctor/patient relationship
13/18
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The Health Care Americans Want
  • Guaranteed access
  • Free choice of doctor
  • High quality
  • Affordability
  • Trust and respect
14/18
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National Health Insurance
  • Universal – covers everyone
  • Comprehensive – all needed care, no co-pays
  • Single, public payer – simplified reimbursement
  • No investor-owned HMOs, hospitals, etc.
  • Improved health planning
  • Public accountability for quality and cost, but minimal bureaucracy
Source: Proposal of the Physicians Working Group for Single Payer NHI. JAMA 2003; 290:798
15/18
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What Would NHI Look Like?
  • Everyone receives a health care card assuring payment for all needed care
  • Complete free choice of doctor and hospital
  • Doctors and hospitals remain independent and non-profit, negotiate fees and budgets with NHP
  • Local planning boards allocate expensive technology
  • Progressive taxes go to Health Care Trust Fund
  • Public agency processes and pays bills
Source: Proposal of the Physicians Working Group for Single Payer NHI. JAMA 2003; 290:798
16/18
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How Do We Know It Can Be Done?
  • Every other industrialized nation has a health care system that assures medical care for all
  • All spend less than we do; most spend less than half
  • Most have lower death rates, more accountability, and higher satisfaction
17/18
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We Have What it Takes
  • Excellent hospitals, empty beds
  • Enough well-trained professionals
  • Superb research
  • Current spending is sufficient
18/18
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Reasons for Single Payer Health Care –
A General Introduction

This slide show was created by Physicians for a National Health Program (pnhp.org) and provides an overview to the problems with our current system and how a single payer system can solve these problems.

This version has been converted from a Powerpoint slide show in order to run in a web browser.

If you would like someone from KYHealthCare to give a similar presentation to your organization, please let us know!

Source: pnhp.org