1. Health Policy 101: Why America Wants NHI Health Policy 101: Why America Wants NHI Walter Tsou, MD, MPH Physicians for a National Health Program Congressional Forum April 24, 2007

2. Americans know more about Anna Nichole Smith than about health care

3. Two Questions?  What is the health policy of the United States of America?  How much will the US spend this year for health care?

4. “Iron Triangle of Health Policy” Access to Care Cost ContainmentQuality of Care

5. Looking at Costs

6. Health Care Costs at $2.3 Tr in 2007 and almost doubles in 9 years. Total for Decade? $31 Trillion!! Source: Projected from Natl Health Expenditures, Health Affairs, Feb. 22, 2006 200708091011121314152016

7. National Health Expenditures (NHE) Share of Gross Domestic Product (GDP) and Private and Public Shares of NHE Source: Heffler, et al. 2005. U.S. Health Spending Projections For 2004-2014. Health Affairs, web-exclusive: w5-74 – w5-85. Public Private funds Public funds

8. US spends far more than other countries on health care OECD, Health Expenditures per capita, 1998

9. Looking at Quality

10. Americans get only 55% of recommended quality indicators McGlynn, E. A. et al. N Engl J Med 2003

11. Problems with the quality of care are indeed widespread and systemic and require a system-wide approach Institute of Medicine, 2003

12. Institute of Medicine, WSJ - June 15, 2006

13. Looking at Access

15. 46.6 Million Uninsured Source: US Census, 2005

16. US Health Policy is a balance between business and public interests Government BusinessPeople

17. What Do Americans Want?

18. NY Times, March 2, 2007

19. Does Business Want Universal Health Care?

20. YES!!

21. Retiree Health Benefits!

22. GM retiree cost is $60 Billion! Source: Wall St. Journal, March 11, 2004

23. GM Lays Off 30,000 Source: NY Times, Nov. 21, 2005 NY Times, Nov 21, 2005

24. Ford Cuts 25,000 Jobs Source: USA Today, Jan 2006 USA Today, Jan 24, 2006

25. Chrysler is in trouble due to health care  “Chrysler faces $21.1 billion in future retiree health care liabilities... and the majority of the obligation is not funded. The massive liability is one of the key hurdles DaimlerChrysler is seen facing as it tries to sell its US unit.” Wall St. Journal, Feb 26, 2007

26. Financial Accounting Standards Board Rule #158  Employers Accounting for Defined Benefit Pension and Other Postretirement Plans  Requiring an employer to recognize the … status of a defined benefit postretirement plan as an asset or liability in its statement of financial position...  Starts Dec. 15, 2006

27. Standard and Poor 500 have $321 Billion Health Care Liability! Source: Wall St. Journal, June 6, 2006

29. $1 Trillion Public Retiree Obligation Source: USA Today, May 18, 2006 oday, May 18, 2006, Reuters June 13, 2006

30. Gov’t Sticker Shock-$600 Billion to $1.3 Trillion Source: WSJ, Nov. 9, 2006 Wall St. Journal, Nov. 9, 2006

31. New estimate of $1.5 Trillion liability, many states are over $10 billion Credit Suisse, March 22, 2007

32. Only 100% Universal Health Care  Discounts future health care costs  Dramatically eliminates retiree health liability on balance sheet

33. Health Care Hits Home...

34. Year ClosedHospitalBedsOutcome 1994Sacred Heart Hospital & Rehab. Ctr234Closed 1995Community Hospital of Chester179Converted to Outpt Clinics 1995Thomas Jefferson UH Ford Road38Converted to Outpt Clinics 1997Allegheny Univ Hospitals, Mt Sinai141Closed 1997Institute of Pennsylvania91Sold to become Kirkbride Center 1999Germantown Hospital88Converted to Outpt Clinics 1999Neumann Medical Center133Converted to Outpt Clinics 2000John F. Kennedy Memorial Hospital103Converted to Outpt Clinics 2000City Avenue Hospital44Closed 2002Mercy Community Hospital113Converted to Outpt Clinics 2003Parkview Hospital149Closed 2003Elkins Park Hospital114Purchased by Einstein Number of Beds removed from Inpatient Use (excl.s Elkins Park, some or all of whose bed capacity will be used by Einstein/MossRehab) 1,22225.3% Bed Capacity Reduction At Hospitals Remaining open3,61574.7% 13 Phila. hospitals have closed from 1994-2004 Source: Delaware Valley Healthcare Council

35. Phila Inquirer, Feb. 17, 2007 Despite a Full Hospital....

36. Single Payer, National Health Insurance

37. A National Health Program  Universal - covers everyone  Comprehensive - all needed care, no co-pays  Single, public payer  No investor-owned HMOs, hospitals, etc.  Improved health planning  Public accountability for quality and cost, but minimal bureaucracy

38. Simplified flow of funds PublicPrivate

39. Public financing, Private delivery

40. Physician Proposal in JAMA, Aug. 2003 www.physiciansproposal.org

41. Congress introduces Physician Proposal Angell Himmelstein Conyers House Judiciary Committee Room, Feb 4, 2003

42. US National Health Insurance Act

43. HEALTH COSTS AS % OF GNP: U.S. & CANADA, 1960-1999 CANADA'S NHP ENACTED NHP FULLY IMPLEMENTED Source: Statistics Canada, Canadian Inst. for Health Info., & NCHS/Commerce Dept

44. Economies of Scale Saves Money

45. U.S. Public Spending Per Capita for Health is Greater than Total Spending in Other Nations Note: Public includes benefit costs for govt. employees & tax subsidy for private insurance Source: NEJM 1999; 340:109; Health Aff 2000; 19(3):150

46. NHI will save $5000 per capita by 2024

47. Independent analysis of single payer for America would save a trillion dollars! National Coalition on Health Care, Aug 1, 2005

48. Government is the “swing” vote Government BusinessPeople

49. Rex Morgan, MD on NHI

50. PHYSICIANS FOR A NATIONAL HEALTH PROGRAM 29 EAST MADISON STREET SUITE 602 CHICAGO, IL 60602-4404 TEL: (312) 554-0382 WWW.PNHP.ORG