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Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care, IU Health Bloomington Assistant Clinical Professor of Medicine, IUSM

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Page 1: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Healthcare for Everyone?

Like the rest of the civilized world

Rob Stone MDDirector, Hoosiers for a Commonsense Health Plan

Director, Palliative Care, IU Health Bloomington Assistant Clinical Professor of Medicine, IUSM

Page 2: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

DISCLOSURES

Dr. Rob Stone has no relevant financial relationships with commercial interests.

Slides can be downloaded at: HCHP.info/Presentations

Page 3: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 4: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Countries with Universal Healthcare

Page 5: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 6: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 7: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 8: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 9: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

What Are We Paying For?

An incredibly complex system Thousands of plans Armies of people to:

-deny coverage and payments- collect payments- determine eligibility

Page 10: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

What Do We Get For Our Money?

The most expensive health care in the world

The best health care in the world?

Page 11: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 12: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 13: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

WHO Global Health Rankings

☤ At the top: France is #1

☤ US ranks 37th, between Costa Rica and Slovenia

Page 14: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 15: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 16: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 17: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Tobacco Smokers

OECD, 2004 (2002 Data, U.K is 2001)

Page 18: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Why spend so much AND get so little?

Reason # 1: Our profit-driven insurance system

AND As long as millions are

left out, everyone will suffer

Page 19: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

US Census Dept, “Income, Poverty, and Health Insurance Coverage” Sept 2012 Himmelstein et al, American Journalof Medicine, August 2009

Health Insecurity Indiana

• 800,000 to 900,000 Hoosiers uninsured

• Hoosier bankruptcy filings because of medical bills:

> 27,000 annually

Page 20: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Is the ACA Going in the Right Direction?

Page 21: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 22: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 23: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 24: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Affordable Care Act

• Original projection: 30-35 million newly covered

• Half thru Health Insurance Exchanges (Mandate)

• Half thru Medicaid expansion• Supreme Court Decision Summer 2012

Page 25: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 26: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Two Very Different Public Programs

MedicarePre-paid health

insuranceWho• Age >65, dialysis,

disability

How• 100% federally funded,

the same in every state

Medicaid The only safety net

Who• Low-income people with

additional eligibility criteria

How• 60% federal, 40% state

funded

Page 27: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Medicaid 101

• Established in 1965 with Medicare • Administered by states within broad federal

parameters

What

• 73% Caucasian, 19% African American, 5% Hispanic

• Largest numbers covered – children • Largest expense – care of frail elderly, esp in

nursing homes

Who

Page 28: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Indiana Medicaid 2014400%

($95,400)

300% ($71,550)

200% ($47,700)

100% ($23,850)

FPL 0 Children Pregna

ntParents Childless Adults

19%

200%250%

Y-axis is % of Federal Poverty Level; Example of a family of four

Premium

NoPremium HIP

Page 29: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

ACA as Planned

Sliding scale premium subsidies:

100% - 400% of poverty level

Medicaid in all states: up to 138% of poverty

100-138% poverty: patient’s choice

Y-axis is % of Federal Poverty Level; Example of a family of four

400% ($95,400)

300% ($71,550)

200% ($47,700)

100% ($23,850)

0

Page 30: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Medicaid Expansion Would Help People We All Rely On

Page 31: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Hoosier Medicaid Expansion

• Estimated 350 – 450 thousand lives covered, ~ half the uninsured

• Largest increase in coverage in >50 years

• $11.50 a day versus $30,000 a year eligibility

Page 32: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Medicaid Expansion – Good for All of Us

• Traditional Medicaid 60/40 Federal/State• ACA Medicaid 100% tapering to 90%

Federal• Cost to Indiana taxpayers: $50-150 million• Federal subsidy: $1.7 billion a year

Page 33: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

A Deal Too Good to Refuse

• HIP cigarette taxes - $121 million• High risk pool - $48 million• Savings from prisons and jails

Page 34: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

“I’m just here for the dental.”

Page 35: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

A Deal Too Good to Refuse

• HIP cigarette taxes - $121 million• High risk pool - $48 million• Savings from prisons and jails• Hospitals avoid $345 M/year unpaid care• 30,000 new jobs• >$100 million new tax revenues

Indiana Hospital Association Report 2/11/13

Page 36: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Indiana Is Being TaxedFor a Program We’re Turning Down

Federal responsibility for cost of expansion population

2014

2015

2016

2017

2018

2019

2020

2021

2022

2023

2024

2025

0%

25%

50%

75%

100%

Our federal tax dollars arepaying for Medicaid but IN is

not getting the benefits

Page 37: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Losing $5 Million a Day

Page 38: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Michigan Chamber Applauds Passage of Medicaid Reform Legislation

“Make no mistake, the Michigan Chamber remains strongly opposed to Obamacare,” said Jim Holcomb, Senior Vice President for the Michigan Chamber. “However, our Board of Directors believes Medicaid reform makes sense for our state and the business community.”

June 13, 2013

Page 39: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Governor Pence has

called Medicaid a

“broken program”

Is Medicaid worse than no insurance at all?

Page 40: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Oregon: Expand Medicaid, Increase ER Usage by 40%

Taubman, S. Science Magazine. Jan 2, 2014.

No Medicaid Medicaid0

1

2

3

4

5

0.68 0.95

Annual emergency

room visits per person

A 40% relative increase means

one extra visit per person

every four years

Page 41: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 42: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Medicaid Expansion Is About

Life and Death In Indiana

Annual data for Indiana from Dickman S, Himmelstein D, McCormick D, and Woolhandler S. Opting out of Medicaid Expansion: The Health and Financial Impacts. Health Affairs Blog. January 30, 2014

Better women’s health• 5,893 more mammograms• 14,246 more Pap smears

Better treatment of chronic diseases• 14,225 more diabetics receiving

medications• 23,971 less adults with depressionFewer preventable deaths• Between 240 and 758 preventable deaths

avoided• Consistent with the “Culture of Life”

Page 43: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

International Timeline of Universal HealthcareGermany 1883

Switzerland 1911New Zealand 1938France 1945United Kingdom 1946Sweden 1947USA 1947*Japan 1961Canada 1966Australia 1974Italy 1978Spain 1986Taiwan 1995

*President Truman proposed but failed to pass National Health Insurance

Page 44: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 45: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

Why Health Care for All -

Young and Old, Rich and Poor?

Page 46: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

What Can We Do?

✔Educate Ourselves✔Find Our Voices✔Join In

Page 47: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,
Page 48: Healthcare for Everyone? Like the rest of the civilized world Rob Stone MD Director, Hoosiers for a Commonsense Health Plan Director, Palliative Care,

PNHP.org