Health Care

Is it a Legal Right No –Not Mentioned in the Constitution –Not wanted by the States –It therefore belongs to the people We view it, however, as a right

Health Care Has Multiple Goals Being Healthy Living a Long Life Having Good Medical Care Making sure Everyone has this These goals make policy difficult

How Much do We Spend 2.2 Trillion Dollars 8000 Per person 16.2% of the GDP

A Hybrid System of Public and Private Modern Health Care is a product of the 1930’s. 46% is paid for by the government The Rest is from employers, and individuals

Where the Money Comes From

What the Government Covers Medicaid Medicare SCHIP Veterans Administration Government Employees

Medicaid Health Care as Welfare Single Largest Welfare program for the poor Fraught with problems

Medicare Health Care for Seniors How it worksworks

Medicare Non-Means Tested Increasingly Expensive Fraught with Problems

Private Insurance Fee For Service Managed Care- 90% of all private insurance

SCHIP Health Care for Children on the Bubble Increasingly Expensive

Terms of Health Care Premium Deductable Copayment

How We Get our Health Care

Strengths of the System Best Doctors and Hospitals Most Advanced Treatment Most Research and Development People with Health Care are satisfied With it.

The Problems of the System Access Cost Quality

The Problem of Access

It is not “46 Million Americans”, but 46 Million in America

The Problem of Access

Why People do not have insurance Who are they?they Health Care is an opportunity cost

Options for the Uninsured E.R. Self Medicate Do Nothing

Problem 2 Quality Quality is maldistributed We focus on sickness, not health We are overspecialized

Problem 3: Cost Outpacing Inflation Why

Cost- Technology MRI’s Bypass surgery Fake Knees and Hips These help us live longer

Cost- Labor 5.5 People per patient Jobs that require skill and education Recession Proof

Cost- Malpractice Actually not the law-suits themselves Defensive medicine High Insurance- just in case

Cost- Greedy people We want to get our benefits back We do not realize the actual costs A “Tragedy of the Commons”

Cost- An Older Population Our last years of life consume much of our health care dollar We are living longer and there are more of us More Care means more $

Cost and Prescription Drugs Average cost is $ in 10 Seniors use a drug Direct to Consumer AdsConsumer

Health Care Reform Insuring more people by changing the number The Million number is gone46-47 Million

Expanding Federal Programs Getting those eligible on programs they are eligible for – Expanding Medicare Eligibility –Expanding COBRA health insurance –Expanding SCHIP Program

Making Changes to Private Insurance Cannot Deny for Pre-Existing Conditions Cannot remove people who use up their coverage The Slackers mandateSlackers Subsidies to purchase insurance

Individual Mandates People will be required to have health insurance –Just as we are required to have health insurance This is the tricky parttricky part

What if I have Insurance In theory it should not change Your employer, however, can just you off

When does it start Mandates begin in 2014 Costs should be lowered over time as people have insurance

How can we afford this 1 Trillion over first 10 years –Tax on TansTans –Higher medicare taxes on wealthy and Medicare cuts –Taxes on High-end insurance –Fees on Health Care Industry