getting real about single payer
TRANSCRIPT
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Getting Real About Single Payer: The Economic Argument for the Long Term
Walter Tsou, MD, MPH
Health Care for All Pennsylvania
February 7, 2015
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Pennsylvania in a Pickle
• $2+ billion dollar deficit
• Revenue from shale gas much less than predicted
• Huge pension obligation
• Restore $1 billion of public education funding?
• Republican legislature tax adverse
• Cut spending? But where?
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What would you cut to get $3 billion?
Zogby, 2014-15 Mid Year Budget Briefing, Dec. 3, 2014
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What is the biggest ignored waste of taxpayer funds?
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US spends more per capita
OECD Health Data, Kaiser Family Foundation
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$750 Billion on Unnecessary Care?
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The Cost of Unnecessary Care?
Institute of Medicine, “Best Care at Lower Cost, Sept 2012
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Billing and Insurance Costs18% of US Health Care Costs
Jiwani et al. BMC Health Services Research (2014)14:556
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Single Payer savings $375 BILLION in US
Jiwani et al. BMC Health Services Research (2014)14:556
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Why single payer saves money?
• Competitive purchasing of services (free market)
• Negotiated fee schedules and prices
• Reduced administrative costs
• Robust information management system
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Affordable Care Act vs. Single Payer
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State single payer bill
• The Family and Business Health Security Act would cost 10% of payroll and 3% personal income tax for individuals
• Comprehensive coverage for all medical, vision, dental, mental health and long term care services
• Coverage for life (eliminates need for retiree health costs for those who stay in Penna)
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Outside Economic Analysis
• Dr. Gerald Friedman, Professor of Economics, Univ. of Massachusetts studied the plan
• $17 billion annual savings
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Education funding
• Restore $1 billion in cuts
• 10% payroll vs. 2009 school district health spending (19.4%)?
• Savings for school districts? $1.15 billion
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Pension funding, 2 parts
• Pensions – wages post retirement –somewhat funded
• Other Post Employment Benefits – pay as you go
– Health care premiums
– Life insurance premiums
– Deferred compensation
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Retiree Health CareThe hidden costs
Zogby, 2014-15 Mid Year Budget Briefing, Dec. 3, 2014
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Accrued Retiree Health Unfunded Liability is over $16 BILLION!
Hay Group, August 21, 2013, “Actuarial Valuation of the Post Retirement Medical Plan”
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Bottom Line, $2.5 Billion annually for Retiree Health Costs just in PA
Hay Group, August 21, 2013, “Actuarial Valuation of the Post Retirement Medical Plan”
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Retiree Health Care Costs
• Only a single payer plan can you guarantee coverage of future health care costs
• Converts an accrual $16 billion liability to a pay as you go liability – much more affordable
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Expand Medicaid
• While we support, it maintains the enormous administrative waste
• No cost containment features
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Summary
• Single payer is the only solution that can generate billions in state savings
• Able to save in education, pensions, and Medicaid
• The alternative budget are unconscionable cuts