Healthcare for All – Washington Washington Health Security Trust: How to get to state-based universal health care 1

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” in a 1966 speech to the Medical Committee for Human Rights 2

Does this make sense to you? 3

Premature death, ages 0-69 U.S. Paying much more while getting much less US Dollars 4 U.S. Health care spending per person Potential years of life lost per 100K

5 The high cost of care in the U.S. Public Citizen, “Severing the Tie That Binds: Why a Publicly Funded, Universal Health Care System Would Be a Boon to U.S. Businesses” healthcare-report.pdf Costs for Selected Procedures, U.S. vs. France (2012 data from International Federation of Health Plans)

The cost of deferred care “Toothache Leads to Boy's Death.” ABC News, March 5, Cost of pulling an abscessed tooth Cost of treating a brain infection $80 $250,000 6 A 12-year-old boy had an abscessed tooth. His mother was unable to pay $80 to have it pulled. He developed a severe brain infection. After two surgeries and weeks of care costing $250,000, he died.

Private insurers’ high overhead 7

8 Complex, bureaucratic intermediaries stand between you and your doctor. Your family Your doctor Private insurers 8 How the U.S. does it

How other countries do it Other countries regard health insurance as a public good.  They cover all residents.  They have fees supervised by the government.  They have no deductibles, though perhaps co-pays.  They have one universal benefit plan.  Supplemental insurance is allowed. 9

Useful features of the Affordable Care Act  Young adults eligible for parents’ insurance  No lifetime limits on coverage  Medicare “donut” hole eliminated over 10 years  Preventive care included at no charge  Price discrimination now limited only to age and tobacco usage  States allowed to innovate with better plans 10

Problems with the Affordable Care Act  25 million or more uninsured after 2017  Provider continuity not guaranteed  Age discrimination in pricing  Half of the States have chosen not to expand Medicaid  Erratic oversight due to regulation at the state level  Four levels of cost sharing based on premium (platinum, gold, silver, bronze) 11

We can do better! Universal coverage:  Everybody in, nobody out  A single agency for health care financing  Publicly financed, but privately delivered  An improved ability to control costs  Continuity of care, regardless of employment status 12

Washington Health Security Trust  All Washington residents covered  Simple, easy to understand  Comprehensive health coverage (medical, vision, and mental health) with no deductibles or co-pays  Choice of any licensed provider  Lower cost - much lower administrative costs and negotiated prices  Purchase of supplementary benefits allowed 13

How the WHST is to be financed 14  Joint Select Committee on Health Care Oversight will: commission an actuarial study devise a financing system to raise sufficient funds  Funding sources may include: an employer assessment on ALL employers an individual premium for all adult residents

Washington Health Security Trust: “What’s in it for me?” 15 Whether you’re insured, uninsured, retired, in school, or unemployed, the WHST will provide:  Lower-cost, high-quality care with choice of any licensed provider  Continuity of health coverage regardless of student or employment status  Possible Medigap coverage, supplementing Medicare Relax! You’re covered.

Moving ahead – state by state  The Washington Health Security Trust (WHST) bill had a House hearing on Feb. 1, 2013; more than 100 people showed up in support of the bill. In the 2015 session it has 40 House and Senate co-sponsors.  In addition to Washington, activists in California, Oregon, Vermont, and many other states are working to implement universal coverage plans. They regularly share information and strategy as part of the group One Payer States. 16

What you can do…. (1)  Talk to your state legislators in Olympia Ask them to publicly support the Washington Health Security Trust, HB 1025 / SB Use the comment link on the official bill website. Tell them your personal story…in 60 seconds!  Talk to everyone you know about the WHST  Book a speaker for your group from Health Care For All-Washington 17

What you can do…. (2)  Join Health Care for All—Washington and be a part of our statewide network of supporters  Meet with us … ●To practice “10 Best Talking Points” ●To plan meetings with legislators ●To rehearse our personal stories 18

Washington Health Security Trust Don’t wait for Congress to act. Universal coverage is possible, state by state! 19 Rev. 2/15