a roadmap for achievable health care reform karen ignagni president and ceo america’s health...
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A Roadmap for Achievable Health Care
ReformKaren IgnagniPresident and CEO
America’s Health Insurance Plans
November 13, 2007
Access ChallengesUninsured Trends
Source: Income, Poverty, and Health Insurance Coverage in the United States: 2005, Census Bureau.
0.0
0.2
0.4
0.6
0.8
1.0
1.2
General Population Low Income (<$25,000)
Moderate Income($25,000 to $49,999)
Upper ModerateIncome ($50,000 to
$74,999)
Growth in Uninsured Rate from 2004 to 2005 (Percentage Points)
Bumps in the Road: Quality Gaps
Evidence Based Medicine: Immediate Improvements Necessary Results of Studies on the Adoption of Evidence Based Medicine
24% Diabetics who received recommended blood-sugar tests over a
2-year period
65% Hypertensive patients who received recommended care
68% Patients with coronary artery disease who received
recommended care
45% Patients with myocardial infarction who received beta-
blockers
64% Elderly patients who received or were offered a
Pneumococcal vaccine
Source: America’s Health Insurance Plans Issue Brief: Making Evidence-Based Medicine The Cornerstone of the U.S. Health Care System
Source: Congressional Budget Office Analysis of Medicare Spending Based Upon the Dartmouth Atlas
Quality ChallengesVariation in Medical Practice
TrendsHow Rising Costs Affect Coverage
0
2
4
6
8
10
12
14
16
18
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Pe
rce
nt
Source for Premiums and Expenditures: Centers for Medicare and Medicaid Services, National Health Expenditures by Type of Service and Source of Funds. Source for uninsured: U.S. Census Bureau.
Uninsured Rate
National Health Expenditures
Private Health Insurance Premiums
Sources: NIH Data Book; Research!America, Investment in U.S. Health Research 2001, 2002, 2004 and 2005
Cost ChallengesTechnology Spending
U.S. Investment in Health Research and Development ($ Billions)
$0
$20
$40
$60
$80
$100
$120
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
Source: The Factors Fueling Rising Healthcare Costs 2006; PricewaterhouseCoopers; 2006
Cost ChallengesCost and Utilization of Care Drive Premium Growth
Source: Differences in Disease Prevalence as a Source of the U.S.-European Health Care Spending Gap; Health Affairs; October 2007
Why is U.S. Health Care Spending So High Compared to Other Nations?
0%
10%
20%
30%
40%
50%
60%
HeartDisease
High BloodPressure
Cancer Diabetes Obese NeverSmoked
Prevalence of Diseases and Lifestyle Choices
United States Europe
Source: Differences in Disease Prevalence as a Source of the U.S.-European Health Care Spending Gap; Health Affairs; October 2007
Why is U.S. Health Care Spending So High Compared to Other Nations?
0%
20%
40%
60%
80%
100%
Heart Disease High Blood Pressure Chronic LungDisease
High Cholesterol Asthma
Proportion of Prevalent Cases Reporting Medication Use Associated with the Condition
United States Europe
What We Have ProposedAddressing Access
SCHIP up to 200% FPL
Medicaid up to 100% FPL
Child Health Credit up to 300% FPL
Universal Health Account with subsidies up to 400% FPL
State Performance Grant
What Voters Think of These ProposalsWhat Voters Think of These Proposals
Question: Now I am going to read some different ideas that some people have proposed for providing health care coverage for people who are currently uninsured. Would you please
tell me if you support or oppose each idea.
Question: Now I am going to read some different ideas that some people have proposed for providing health care coverage for people who are currently uninsured. Would you please
tell me if you support or oppose each idea.
Giving a federal tax credit to low and moderate income parents
Increasing funding for health insurance program for children
Providing grants from the federal government
Having the federal government match contributions
Giving federal tax deduction for purchase of private insurance
Expanding the federal government’s Medicaid program
Establishing a tax-free Health Account for all Americans 65%
69%
69%
69%
71%
77%
85%
Ranked by Percent “Support”
83%
65%
63%
75%
54%
66%
59%
88%
89%
77%
68%
82%
65%
82%
83%
75%
67%
69%
67%
64%
69%
Rep Ind Dem
Create a new entity for comparative effectiveness
Set a national research agenda to address gaps in evidence
Accelerate efforts to give patients and their physicians the necessary information to make value-based decisions
Emphasize the adoption of best practices
Develop innovative tools to help physicians and patients manage chronic conditions
Create a new medical dispute resolution system to resolve disputes fast, fairly, and effectively
What We Have ProposedAddressing Quality
Disease management, care coordination and prevention programs
Pay for performance
Investments in health information technology
More information regarding the cost and quality of care
Consideration of a reinsurance program to help pay for experimental therapies to make emerging therapies more accessible
Medical liability reform
What We Have ProposedAddressing Costs
The challenges are palpable to the public
Health care is number one domestic policy issue among voters
Solutions must appeal to red, blue and purple electorate
Must address costs, quality and access together to enact effective reform
Conclusion
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