Download - Health Care for All Colorado
![Page 1: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/1.jpg)
Health Care for
All Colorado
Irene Aguilar, M.D. Vice President,
Health Care for All Colorado
Primary Care PhysicianWestside Health Center
Denver Health and Hospitals
![Page 2: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/2.jpg)
Health Care Spending in the U.S.
2006 - $2.1 trillion (16% GDP)69% for health care31% for other costs
Administrative overheadProfits
2007 - $2.4 trillion (21% GDP)Colorado spending 2007 estimated at: $30.1 billion
![Page 3: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/3.jpg)
Government Insurance 2006: 80.3 M 2007: 83.0 M 2.3 Million
2007: 45.7 Million Uninsured
2007 Colorado: 801,000 uninsured16.4% of population
![Page 4: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/4.jpg)
In Colorado, 70% of the uninsured are in the workforce or are dependents of a worker.
![Page 5: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/5.jpg)
What is the cost of health insurance? Over $10,000 for employer sponsored family
policy*
Individual policy (if it can be purchased) more than $10,000 in after tax dollars
Median income was $52,275 in 2006**
Can the average worker afford health insurance?
*The Lewin Group: Health Spending in Colorado June 2007**Denver Business Journal August 2007
![Page 6: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/6.jpg)
0100200300400500600700800
$$
Average Total Employee Contribution per Enrolled Employee for Single Coverage at Private-Sector
Establishments Offering Health Insurance in Colorado
![Page 7: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/7.jpg)
Because of rising costs, the numbers of companies
offering health benefits continues to decline
1995 – 67%2000 – 51%2007 – 41%
National Small Business Association Survey - 2007
37.5% of Colorado’s uninsured work for firms that do not offer insurance;21% are ineligible for their employer’s coverage
![Page 8: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/8.jpg)
37% of companies have taken cost cutting action
Instituting wellness programs Changing insurance company Decreasing covered benefits Increasing deductibles and co-pays Increasing employee contribution
![Page 9: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/9.jpg)
![Page 10: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/10.jpg)
![Page 11: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/11.jpg)
![Page 12: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/12.jpg)
![Page 13: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/13.jpg)
Access Problems for Middle Class Families
(Income $25,000-$49,999)
22% 23%
13% 12%
0%
5%
10%
15%
20%
25%
Postponed Needed Care Problem Paying BillsDidn't Get Needed Drug Collection Agency Call
NPR/Kaiser Survey, June2002
![Page 14: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/14.jpg)
![Page 15: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/15.jpg)
Who Pays for Health Care?
Private health insurersInsure 59% of those with insurance
Pay 19% of total health care costs
![Page 16: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/16.jpg)
Who Pays for Health Care?Government (taxpayers) – 66%Federal/State/Local
Medicare - $440 billion (2006)Medicaid - $330 billion (2006)SCHIPGovernment Employee Insurance PremiumsU.S. Public Health Services (IHS)U.S. MilitaryVA System (235,000 employees)Prisoners (2 million incarcerated) Public hospitals and clinicsTax subsidies
![Page 17: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/17.jpg)
Health Care Expenditure per Capitaby Source of Funding in 2005Adjusted for Differences in Cost of Living
$2,884 $2,693 $2,527 $2,337 $2,064 $2,110 $1,829
$2,676
$448$328 $507 $832 $390
$121
$842
$233 $431 $482
$392
$2,110
$352$0$250 $627
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
UnitedStates
France Germany Canada Netherlands Australia UnitedK ingdom
NewZealand
Out-of-Pocket SpendingPrivate SpendingPublic Spending
ab
a2004b2002
Source: OECD Health Data 2007
![Page 18: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/18.jpg)
Average Length of Stay in Hospital in 2005
5.45.65.66.16.16.8
7.38.6
0
2
4
6
8
10
GER CAN NETH AUS UK NZ US FR
a2004b2003cSource: NZ Ministry of Health, 2004
aa c
Source: OECD Health Data 2007 (October 2007)
7.06.6 6.1 6.0
5.4 5.1
3.83.2
0
2
4
6
8
10
GER FR AUS CAN NETH UK US NZ
Average Number of Physician Visits per Capita in 2005
Utilization of Health Care Services
ba a aa
![Page 19: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/19.jpg)
![Page 20: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/20.jpg)
![Page 21: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/21.jpg)
In comparison to other countries, why do we: Have 97 million uninsured or
underinsured? Spend far more per capita? Have poorer outcomes? In other words… Where is the money?
![Page 22: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/22.jpg)
![Page 23: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/23.jpg)
Growth of Registered Nurses and Administrators, 1970-2002
Bureau of Labor Statistics & Himmelstein/Woolhandler/Lewontin Analysis of CPS data
0%
500%
1000%
1500%
2000%
2500%
1970 1975 1980 1985 1990 1995 2002
Gro
wth
sin
ce 1
970
Administrators RNs
![Page 24: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/24.jpg)
![Page 25: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/25.jpg)
![Page 26: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/26.jpg)
What role do medical liability costs play?
3% of total costs ($66 billion) Majority of patients who are harmed
are not compensated Some not harmed are compensated Tort reform is not the comprehensive
solution to health care costs
![Page 27: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/27.jpg)
MEDICAL MALPRACTICE INSURANCE2000-2004
9.6%
134.5%
0%20%40%60%80%
100%120%140%160%
Payout Increase Premiums IncreaseGross Losses Paid Gross Premiums Written
Falling Claims and Rising Premiums in the Medical Malpractice Insurance Industry, July 2005
![Page 28: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/28.jpg)
![Page 29: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/29.jpg)
Drug Companies’ Cost Structure
![Page 30: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/30.jpg)
U.S. Drug Spending, 1990-2003
Source: HCFA, Office of the Actuary
$40$46 $48 $51 $55
$61 $67$75
$104
$122
$142
$161
$182
$85
» 0
» 20
» 40
» 60
» 80
» 100
» 120
» 140
» 160
» 180
» 200
1990 1992 1994 1996 1998 2000 2002
»P
resc
riptio
n D
rug
Spe
ndin
g »
(Bill
ions
of D
olla
rs)
![Page 31: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/31.jpg)
![Page 32: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/32.jpg)
![Page 33: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/33.jpg)
![Page 34: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/34.jpg)
The Health Care Americans Want
Free choice of doctorGuaranteed accessHigh qualityAffordabilityTrust and Respect
![Page 35: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/35.jpg)
The Health Care Americans Get
1/3 are uninsured or underinsured Insurance companies deny care to millions more
with expensive illnesses Death rates higher than other wealthy nations Costs exceed France, Germany and Sweden and
rising faster Executives and investors making billions Destruction of the doctor/patient relationship
![Page 36: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/36.jpg)
Medicare, Medicaid and Choice or
Insurance does not = Access
Only 37% of Colorado Providers accept Medicaid (adult and children)
In 2002 only 37% of primary care physicians were accepting new Medicare patients
![Page 37: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/37.jpg)
How do we achieve the ideal?Dramatically reduce
overhead costs. How?
Eliminate “for profit” entities in delivery of healthcare
Reduce costs of pharmaceuticals Allow negotiation of bulk price
Create a single risk pool of all residents - makes health care available and affordable to all
![Page 38: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/38.jpg)
Lewin Group Analysis of Colorado Proposals*
COLORADO HEALTH SERVICES SINGLE PAYER PROGRAM
Everyone insured with comprehensive benefits – No one without coverage
$1.4 billion savings annually
*Colorado Blue Ribbon Commission on Health Care Reform 1/31/2008
![Page 39: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/39.jpg)
Single Payer Health Care Universal – covers everyone Comprehensive – all needed care, including
dental, mental health, substance abuse No or low co-pays Simplified reimbursement No for profit insurers, hospitals, etc Improved health planning Public accountability for quality and cost, with
minimal bureaucracy
![Page 40: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/40.jpg)
Single Payer Health Care:How do we know it can be done?
Every other industrialized nation has a healthcare system that assures medical care for all
All spend less than we do; many spend less than half
Most have lower death rates, more accountability and higher satisfaction
![Page 41: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/41.jpg)
Single Payer Health Care Opponents
Insurance companies - lose business and lose profit
Pharmaceutical companies - lose profit Many providers - fear change Some small businesses - forced to pay
a share The insured – fear less coverage and
more costs
![Page 42: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/42.jpg)
Single Payer Health Care Supporters
The uninsured - all would be covered The elderly & middle class - ends
underinsurance and risk of bankruptcy Medicaid & Medicare recipients - assures
equal choice in care Big business - contains costs Health Care Providers - helps patients,
curtails bureaucracy Employees – bargain for salary increases
instead of health benefits
![Page 43: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/43.jpg)
![Page 44: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/44.jpg)
Single-payer orNational Health Insurance.
U.S. Physicians
Support59%
Oppose32%
No Opinion9%
Support for National Health Insurance among U.S. Physicians: 5 Years LaterCarroll and Ackerman Ann Intern Med.2008; 148: 566-567
![Page 45: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/45.jpg)
Elected leadership should work for taxpayers, not for special interests.
Our healthcare dollars should be spent to guarantee access to comprehensive high quality health care.
We need to advocate for REAL healthcare reform.
![Page 46: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/46.jpg)
What can you do?Write your federal legislators and ask
them to endorse HR 676 – Improved Medicare for All
Talk to your state legislators and ask them to support Single Payer Health Care in Colorado
Educate yourself about the REAL ISSUES in health care reform
Join us : www.healthcareforallcolorado.org
![Page 47: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/47.jpg)
“True compassion is more than flinging a coin to a beggar;
it comes to see that an edifice which produces beggars
needs restructuring.
Martin Luther King, Jr.
![Page 48: Health Care for All Colorado](https://reader036.vdocuments.net/reader036/viewer/2022081514/568168a2550346895ddf399d/html5/thumbnails/48.jpg)
Stephen Colbert on the Bush Health Plan
“It’s so simple. Most people who can’t afford health insurance are also too poor to owe taxes. But if you give them a deduction from the taxes they don’t owe, they can use the money they’re not getting back to buy the health care they can’t afford.”