Reforming Health Care: Making Sense of Health Care Finance amid Growing Underinsurance Leonard Rodberg, PhD Urban Studies Dept., Queens College/CUNY Prepared.

Slides:



Advertisements
Similar presentations
More Security and Stability If You Have Health Insurance, the Obama Plan: Ends discrimination against people with pre-existing conditions. Limits premium.
Advertisements

THE COMMONWEALTH FUND Health Care Reform in the 2008 Presidential Election Sara R. Collins, Ph.D. Assistant Vice President The Commonwealth Fund Alliance.
THE COMMONWEALTH FUND The Future of Employer-Sponsored Health Insurance The Commonwealth Fund and The Century Foundation Business and National Health Care.
THE COMMONWEALTH FUND Rising Health Care Costs: Implications for the Health and Financial Security of U.S. Families Sara R. Collins, Ph.D. Assistant Vice.
WHY THE UNITED STATES NEEDS A NATIONAL HEALTH PROGRAM A NATIONAL HEALTH PROGRAM Presented by Mary E. O’Brien, M.D. Columbia University Health Service Physicians.
Health Care in Obama’s 1st Year: More of the Same is not Reform – It’s a Placebo Leonard Rodberg, PhD Urban Studies Dept., Queens College/CUNY and NY Metro.
Prepared for the Committee for Health Care for Massachusetts December 14, 2005 ACTION COSTS LESS The Health Care Amendment Standards and Options for Reform.
Policy Proposals Health Care Coverage, Costs, and Financing.
 The Patient Protection and Affordable Care Act : How will ACA Impact Small Business? Sponsors: St. Tammany Democratic Parish Executive Committee (DPEC)
Health Care Reform in Obama’s First 100 Days Leonard Rodberg, PhD Urban Studies Dept., Queens College/CUNY and NY Metro Chapter, Physicians for a National.
Health Care in Obama’s 1st Year or More of the Same is not Health Care Reform Leonard Rodberg, PhD Urban Studies Dept., Queens College/CUNY and NY Metro.
SINGLE PAYER The Next Step for Health Reform (Beyond the Affordable Care Act of 2010) Prepared by Randy Block Co-Chair, Gray Panthers of Metro Detroit.
FIFTY YEARS IN MEDICINE, : WHERE ARE WE HEADED NOW? John P. Geyman, M.D. 50 th Reunion, Class of 1960 UCSF School of Medicine.
THE COMMONWEALTH FUND 1 Benefit Design: Access, Affordability, Risk Pooling Cathy Schoen Senior Vice President, Commonwealth Fund Benefits in Health Insurance.
THE COMMONWEALTH FUND New Evidence on Health Coverage For Aging Boomers: Findings from the Commonwealth Fund Survey of Older Adults Sara R. Collins, Ph.D.
Stakeholder Presentation---Payers MGMT E-5520 Jenny Ou October 21, 2010.
Proposals for “Universal” Health Care or Back to the Health Care Future Leonard Rodberg Urban Studies Dept, Queens College And NY Metro Chapter Physicians.
Medicare spending is 14% of the federal budget Total Federal Spending in 2013: $3.5 Trillion MEDICARE Medicaid Net interest Social Security Defense Nondefense.
The Tattered Safety Net James G. Anderson, Ph.D. Purdue University.
Major Health Issues The Affordable Healthcare Act.
Growing Unaffordability of Health Care: Incremental vs. Real Health Care Reform John P. Geyman, MD Professor Emeritus- Family Medicine University of Washington,
NATIONAL HEALTH INSURANCE FOR THE U.S.: HAS ITS TIME COME? Presented by Physicians for a National Health Program New York Metro Chapter.
Health Care Delivery Systems. Health Insurance Coverage that provides for the payments of benefits as a result of sickness or injury. Includes insurance.
THE COMMONWEALTH FUND THE COMMONWEALTH FUND Realizing Health Reform’s Potential: Small Businesses and the Affordable Care Act of 2010 Sara R. Collins,
THE COMMONWEALTH FUND 1 Figure 1. We Can’t Continue on Our Current Path: Growth in the Uninsured Data: Analysis of the U.S. Census Bureau, Current Population.
Proposals for “Universal” Health Care or Back to the Health Care Future Leonard Rodberg Urban Studies Dept., Queens College/CUNY and NY Metro Chapter Physicians.
PROPOSALS FOR HEALTH CARE REFORM: WHAT IS “REALISTIC”? Leonard Rodberg, PhD Urban Studies Dept., Queens College/CUNY and NY Metro Chapter Physicians for.
Healthcare Calculator Estimate your savings with HR 676 “The United States National Health Care Act” or “Expanded and Improved Medicare for All”
Health Reform: What It Means to Our Community. Health Reform: Key Provisions o Provides coverage to 32 million uninsured people by o Changes insurance.
The New Health Reform Law: What Does It Mean? Will It Work? Leonard Rodberg, PhD Urban Studies Dept., Queens College/CUNY and NY Metro Chapter, Physicians.
Figure ES-1. Key Differences Between the Presidential Candidates’ Health Reform Plans McCainObama Aims to Cover EveryoneNot a GoalGoal Rules for Individual.
Comparison of Major Health Care Reform Proposals BushKerry Aims to Cover All Americans X Tax Credits for Premiums XX Automatic Enrollment/ Individual Mandate.
Excess cost growth in Medicare, Medicaid, and all other health care spending Source: CBO, A Federal Perspective on Health Care Policy and Costs, 2008.
Health Care Reform in America Facing Up:. President Obama and Healthcare Reform “Health care reform is no longer just a moral imperative, it’s a fiscal.
Exhibit ES-1. Synergistic Strategy: Potential Cumulative Savings Compared with Current Baseline Projection, 2013–2023 Total NHE Federal government State.
Exhibit 1. “Medicare Extra” Benefits vs. Current Medicare Benefits Current Medicare benefits*“Medicare Extra” Deductible Hospital: $1024/benefit period.
Spotlight on the Federal Health Care Reform Law. 2. The Health Care and Education Affordability Reconciliation Act of 2010 was signed March 30, 2010.
Medicare, Medicaid, and Health Care Reform Todd Gilmer, PhD Professor of Health Policy and Economics Department of Family and Preventive Medicine 1.
The Patient Protection and Affordable Care Act Our Healthcare Reform Law Why do we need it? What does it do for us?
THE COMMONWEALTH FUND The 2009 Congressional Health Reform Bills: Insurance Coverage Sara R. Collins, Ph.D., Vice President Rachel Nuzum, M.P.H., Senior.
Health Care Reform Lexicon John Dante, FSA, MAAA, FCA President and CEO Dante Actuarial Consulting, LLC Actuaries Club of Philadelphia Meeting November.
Natalie Brisighella. 1.Current System 2.Proposed Plan Details 3.Negative Consequences of Plan 4.Additional Arguments 5.Refutation of Proponents’ Arguments.
Percent of total Medicare population: NOTE: ADL is activity of daily living. SOURCES: Income and savings data from Urban Institute/Kaiser Family Foundation.
The New Medicare Prescription Drug Benefit: An Overview Prepared by: Michelle Kitchman, M.H.S. Kaiser Family Foundation For the: California Senate Health.
Return to Tutorials Tricia Neuman, Sc.D. Director, Medicare Policy Project Vice President, Kaiser Family Foundation For KaiserEDU June 2009 Medicare 101:
Health Care Reform Post-Election : What is “Realistic”? Leonard Rodberg, PhD Urban Studies Dept., Queens College/CUNY and NY Metro Chapter, Physicians.
The Great Healthcare Debate Presentation made by: Alex Garcia, Carlo Torres, Edgar Castillo, Gricelda Vera, Lorena Arroyo, and Margarito Rofledo.
THE COMMONWEALTH FUND Karen Davis President, The Commonwealth Fund January 27, Health Savings Accounts.
Gerald Friedman Professor of Economics
Health Reform 2014 Bill Graham VP, Policy & Government Affairs August 17, 2010.
Dennis & Patten Participation in Government Mepham High School Health Care Reform in America.
Applying a Gold Standard to Our Health Care System: The Institute of Medicine and the Affordable Care Act Peter Mahr, MD October 13, 2015.
HEALTH REFORM IN THE 2004 ELECTION Candidates’ Health Policy Agendas Moderator : Jeanne Lambrew, George Washington University AcademyHealth National Health.
The Affordable Care Act (Obamacare) and the Single Payer Alternative Leonard Rodberg Professor and Chair, Urban Studies Department, Queens College and.
Figure ES-1. Features of Leading Candidates’ Approaches to Health Care Reform ClintonEdwardsObamaGiulianiHuckabeeMcCainRomney Individual Mandate Yes Children.
The Building Blocks of Health Reform: Achieving Universal Coverage and Health System Savings Cathy Schoen Senior Vice President, The Commonwealth Fund.
EXPLORING MARRIAGES AND FAMILY, 2 ND EDITION Karen Seccombe © 2015, 2012 by Pearson Education, Inc. All rights reserved. Chapter 10 Families and the Work.
More Security and Stability If You Have Health Insurance, the Obama Plan: Ends discrimination against people with pre-existing conditions. Limits premium.
U.S. Health Care System – Jenny Lee INEKO, Michigan Law School Student June 14, 2004.
Health Reform: An Overview Unit 4 Seminar. The Decision The opinions spanned 193 pages, upholding the individual insurance mandate while reflecting a.
Students for a National Health Program (SNaHP) Surprising Statistics Supporting Single Payer!
THE NEW YORK HEALTH ACT: Single Payer Health Care for New York State May 2016.
The U.S. Health Care System: An International Perspective
Intersections of Health Care Reform A critical discussion
Intersections of Health Care Reform A critical discussion
An Estimated 116 Million Adults Were Uninsured, Underinsured, Reported a Medical Bill Problem, and/or Did Not Access Needed Health Care Because of Cost,
President Bush’s Health Plan
Presentation transcript:

Reforming Health Care: Making Sense of Health Care Finance amid Growing Underinsurance Leonard Rodberg, PhD Urban Studies Dept., Queens College/CUNY Prepared for the Congressional Forum on National Lessons for Health Reform: Examining US Health Insurance April 1, 2009

International Comparison: Universal Coverage at Less Cost -- They Must Be Doing Something Right! * PPP = Purchasing Power Parity. Data: OECD Health Data 2008, June 2008 version. Average spending on health per capita ($US PPP*) All have a strong role for government in funding and regulating their health care system.

An Estimated 116 Million Adults Were Uninsured or Underinsured in 2007 Medical bill/debt problem 17.7 million 10% Cost-related access problem 25.9 million 15%. Source: S. R. Collins, J. L. Kriss, M. M. Doty, and S. D. Rustgi, Losing Ground: How the Loss of Adequate Health Insurance Is Burdening Working Families: Findings from the Commonwealth Fund Biennial Health Insurance Surveys, 2001–2007, The Commonwealth Fund, Aug Adequate coverage and no bill or access problem 61.4 million 35% Uninsured anytime during the year 17.6 million 10% Medical bill/debt and cost-related access problem 54.4 million 31% 177 million adults, ages 19–64 Millions are Uninsured and Underinsured

Medical costs create serious financial problems for millions of us Source: Health Tracking Poll, Kaiser Family Foundation, April 2008

Underinsurance is Growing Source: Too Great a Burden, Families USA, December 2007 Number of people in families spending more than 10% of pre-tax income on health care (millions)

An Example of Underinsurance on the Federal Employee Health Benefit Program Total Bill Co-pay Two days in a hospital for bronchitis & heart exam:

This Year’s Underinsured Source: Medical Expenditure Panel Survey, US Agency for Healthcare Research and Quality, 1999 Percent of Health Care Costs Health Care Costs Are Concentrated Among a Few People in Any One Year We’re all underinsured --it’s just that we don’t know it until we get sick and need our insurance!

Everyone mandated to have insurance Employers should offer insurance or contribute Continued reliance on private insurance, with the option of a public Medicare-like plan You can “Keep what you have” -- doesn’t address widespread underinsurance: For most families, the problem is not the lack of insurance, it’s the insurance they already have! No regulation of insurance company premiums or practices Increases cost of the system by hundreds of billions of dollars No way to control costs so long as there are many separate plans and payers. The Private/Public Mandate Model Nixon  Obama

CBO: Mandate Plans Will Not Lead to Universal Health Care or Cut Costs “…national compliance rates [with mandates] range from 63 percent to 86 percent.” (p. 49) “The adoption of more health IT offers many benefits, but it is generally not sufficient to produce substantial cost savings.” (p.147) “The evidence was insufficient to conclude that disease management programs generally reduce health care spending.”(p. 142) “Although new research into comparative effectiveness might lead to net cost savings over a long period of time, its effects during the conventional 10-year horizon for budgetary estimates would be limited.” (p.146) Source: Key Issues in Analyzing Major Health Insurance Proposals, Congressional Budget Office, December 2008.

Conyers: Expanded and Improved Medicare for All “ single payer national health insurance” HR 676 Automatic enrollment Comprehensive benefits Free choice of doctor and hospital Doctors and hospitals remain independent Public agency processes and pays bills Financed through progressive taxes Costs contained through capital planning, budgets, emphasis on primary care

How Single Payer Could Be Paid For: One Example from a Recent Study of a California Plan

Billing and Insurance: Nearly 30% of All Health Care Spending 28%

Covering Everyone with No Additional Spending Additional costs Covering the uninsured and poorly-insured +6.4% Elimination of cost-sharing and co-pays +5.1% Savings Reduced hospital administrative costs -1.9% Reduced physician office costs -3.6% Reduced insurance administrative costs -5.3% Bulk purchasing of drugs & equipment -2.8% Primary care emphasis & reduce fraud -2.2% Source: Health Care for All Californians Plan, Lewin Group, January $ B Total Costs +11.5% Total Savings -15.8% Net Savings - 4.3% - 73

The Bottom Line The Private-Public Mandate model will Make the world’s most expensive system even costlier. Not improve insurance coverage for the average person. Not make affordable insurance available. Not contain the continuing growth in cost. In other words, it won’t work! Only single payer national health insurance will Cover everyone for comprehensive services. Cost no more than we are now spending. Provide mechanisms for containing the growth in cost.

Will We Get Real Health Care Reform Before the Premium Takes All our Income? Source: American Family Physician, November 14, 2005 Today