1. Actuaries Club of Philadelphia Meeting February 16, 2010 John Dante, FSA, MAAA, FCA President and CEO Dante Actuarial Consulting, LLC

3. No. 221Japan2.79 No. 217France3.33 No. 210Germany3.99 No. 196Australia4.75 No. 194United Kingdom4.85 No. 190Canada5.04 No. 186Italy5.51 No. 180United States6.22 2009 Estimated Deaths per 1,000 Live Births Per CIA World Factbook

4. No. 3Japan82.1 No. 6Australia81.6 No. 7Canada81.2 No. 8France81.0 No. 10Switzerland80.9 No. 18Italy80.2 No. 32Germany79.3 No. 36United Kingdom79.0 No. 49United States78.1 2009 Estimated per CIA World Factbook

5. No. 1Japan74.5 No. 2Australia73.5 No. 3France73.1 No. 6Italy72.7 No. 8Switzerland72.5 No. 24United States70.0 World Health Organization, The World Health Report 2000 Average life expectancy before disabling diseases of old age

6. No. 1France65 No. 2Japan71 No. 3Australia71 No. 5Italy74 No. 6Canada77 No. 12Germany90 No. 16United Kingdom103 No. 19United States110 Preventable deaths per 100,000 of population Source: Commonwealth Fund (2002-2003)

7. Why are we the only developed country where healthcare coverage is a privilege and not a right?

8. Why are we the only developed country where medical bills can result in a person having to declare bankruptcy?

9. 1. It is socialized medicine 2. They ration care 3. There are long waits 4. There are limited choices

10. Government providers Government pays the bills Britain, Spain, Italy and Cuba But GPs in Britain are private business people

11. Canada, South Korea and Taiwan – Government insurance with private hospitals, doctors and labs France, Germany, Netherlands, Switzerland and Japan – some Government oversight

12. Government Takeover of Healthcare Medicare ? Veterans Administration ? Government Negotiation ?

13. Only instance I found: Britain’s National Institute of Health and Clinical Excellence (NICE)

14. Germany, France, Sweden & Denmark have shorter waits to see a specialist or have elective surgery than United States

15. Britain and Canada have issues with waits In Japan, you don’t even need to make an appointment

16. We limit in the US today: Medicare, HMOs, etc. Truth: many countries provide more choices In Germany, individuals have choice of any of 200+ private health insurance plans

17. In Switzerland and the Netherlands, Individuals can choose any insurance plan France and Japan – designated insurer but can see any provider Canada – Government insures but can also see any provider

18. 1.“No matter how good the healthcare in a particular country, people will complain about it.” 2.“No matter how much money is spent on healthcare, the doctors and hospitals will argue that it is not enough.” 3.“The last reform always failed.”

19. United States: 20% Canada: 6% France: 5% Taiwan: 2% Medicare: 3%

20. American Healthcare “Providers” (doctors, nurses, hospitals, drug companies) make more than their counterparts overseas Student Debt and Malpractice

21. The way we manage health insurance and the complexity of our system US is only developed country that relies on profit making insurance companies to pay for essential and elective care

24. John Dante, FSA, MAAA, FCA President and CEO Dante Actuarial Consulting, LLC E-mail: johndante@danteactuarial.com Phone: 570-417-9039