Universal
Healthcare and
Single-Payer
v7.3 01/27/10
JB Fenix, MPH, CaPA Fellow 2009-2010
MD degree candidate 2011
CaPA.Fellow@PNHP.org
www.PNHP.org
Who am I?

CaPA and PNHP




California Physicians’ Alliance
Physicians for a National Health Program
http://www.PNHP.org
The CaHPSA team



California Health Professional Student Alliance
Check out the website: http://www.CaHPSA.org/
Check out the Facebook Group (search “CaHPSA”)!
Overview
 How
this affects you!
 The problem.
 Potential solutions.
 Common concerns.
 Taking action.
How this
affects you!
This is a moral and ethical issue!
“Of all the forms of inequality, injustice in
healthcare is the most shocking and
inhumane.”
-- Rev. Martin Luther King, Jr.

We must be leaders on this issue.

We have an ethical responsibility to follow the
evidence and be guided by our principles.
The
Problem.
The Problem.
Poor
 The
Outcomes.
Uninsured.
 The Underinsured.
 High Costs.
Mortality Amenable to Health Care:
U.S. Failing to Keep Pace with Other Countries
Deaths per 100,000 population*
1997/98
150
2002/03
130
99
100
76
81
88
84
89
89
97
50
65
71
71
74
74
77
80
82
109
106
84
90
116
115
93
96
134
128
115
113
97
88
82
84
101
103
103
104
110
Fr
an
ce
Ja
p
Au an
st
ra
lia
Sp
ai
n
Ita
Ca ly
na
d
No a
Ne
r
th way
er
la
n
Sw ds
ed
e
Gr n
ee
c
Au e
s
Ge tria
rm
an
y
F
Ne inl
an
w
Ze d
al
De and
Un
nm
ite
d
Ki ark
ng
do
m
Ire
la
Po nd
Un
r
ite tug
a
d
St l
at
es
0
* Countries’ age-standardized death rates before age 75; including ischemic heart disease,
diabetes, stroke, and bacterial infections.
Data: E. Nolte and C. M. McKee, London School of Hygiene and Tropical Medicine analysis of
World Health Organization mortality files (Nolte and McKee, Health Affairs 2008).
Source: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2008.
The Problem.
 Poor
Outcomes.
The
 The
Uninsured.
Underinsured.
 High Costs.
The
Uninsured
>46 Million
Uninsured in
the US.
>6.5 Million
Uninsured in
the California.
•US Census Bureau Data
•CHIS, 2005
The Uninsured - Toll on the
Communities and the Country

The diminished health and shorter life spans of
Americans who lack health insurance are worth
between $65 billion and $130 billion for each year
spent without health insurance.

Communities with high uninsured rates have
reduced access to essential services and
community overall health status is adversely
affected.
Insuring America’s Health, Institute of Medicine 2004.
The Bottom Line
>40,000
deaths annually
due to
lack of coverage
Source: Wilper et al. 2009. American Journal
of Public Health
The Problem.
 Poor
Outcomes.
 The Uninsured.
The
 High
Underinsured.
Costs.
The Underinsured and
Barriers to Healthcare

Unaffordable co-pays, and deductibles

Benefits not included  Rx Drugs, specialists

Denial for “pre-existing conditions”

Little or no ability to choose doctor
Blewett et al. 2006. Medical Care Research and Review; Michael Moore. 2007. “SiCKO”
% with same doctor > 5 years
Lack of continuity of care
amongst the Underinsured
100%
80%
60%
45%
52%
65%
65%
Australia
U.K.
57%
40%
20%
0%
U.S.
New
Zealand
Commonwealth Fund Survey, 1998
Canada
% finding it difficult to get care
Difficulty accessing care
amongst the Underinsured
30
28
25
21
20
15
15
15
New Zealand
Australia
U.K.
15
10
5
0
U.S.
Canada
Commonwealth Fund Survey, 1998
The Problem.
 Poor
Outcomes.
 The Uninsured.
 The Underinsured.
High
Costs.
Income Growth vs Premium Growth
Am Fam Physician, 72(10):2005
Where is the
money going?
•Unnecessary care…
•Malpractice and defensive medicine…
•Administrative costs…
Where is the money going?
Number of Administrators
Growth since 1970
Number of RNs
2500%
2000%
1500%
1000%
500%
0%
1970
1975
1980
1985
1990
1995
Source: Bureau of Labor Statistics & Himmelstein/Woolhandler/Lewontin Analysis of CPS data
2001
Where is the money going?
Number of Administrators
Growth since 1970
Number of Physicians
2500%
2000%
1500%
1000%
500%
0%
1970 1975 1980 1985 1990 1995 2000
Source: Bureau of Labor Statistics & Himmelstein/Woolhandler/Lewontin Analysis of CPS data
U.S. Overhead Spending
30%
26.5%
19.9%
20%
16.3%
10%
3.1%
0%
Medicare
Non-Profit Blues
Commercial
Carriers
International Journal of Health Services 2005; 35(1): 64-90
Investor-Owned
Blues
But maybe?...

Maybe market competition is
driving towards lower costs, and
better quality?...
For-Profit Hospitals’ Cost More
For-Profit Hospitals’ Death Rates are Higher
The Unit of
competition matters!
Health of the patient vs. the health of the investor
Potential
Solutions.
WWW.IOM.EDU
Guiding Principles
1.
2.
3.
4.
5.
Health care coverage should be universal.
Health care coverage should be continuous.
Health care coverage should be affordable to
individuals and families.
The health insurance strategy should be
affordable and sustainable for society.
Health care coverage should enhance health and
well-being by promoting access to high quality
care that is effective, efficient, safe, timely, patientcentered and equitable.
Alternative Solutions
Major public program extension and
new tax credit.
 Employer mandate, premium
subsidy, and individual mandate.
 Individual mandate and tax credit.
 Single-payer system.

Nothing is perfect!
Employer and Individual Mandate with
Premium Subsidy (aka Current National
Reform)
Universal?
Higher but not universal.
Continuous?
Brief gaps.
Affordable?
If adequate employer
premium support.
Dependent on employer
input.
Similar to status quo;
possibly improved with
expanded public
program.
Sustainable?
Promotes access to
high quality care?
Mandate Problems.

Do we want to criminalize healthcare?

Will we get minimum benefit packages?

Will we get maximum cost ceilings?

Will insurance companies cover everyone?
Tax Credits. Summed up by
Stephen Colbert

“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.”
…maybe incremental
reform is a step in the right
direction?

Lessons from other states…
Minnesota 1992/1993
“Minnesota has set a goal of achieving
universal coverage by July 1, 1997. In
1992, the state passed legislation to
subsidize premiums for the uninsured and
let employers buy coverage from a state
pool.”
“‘Minnesota is about to embark on a
plan to solve the health-insurance
crisis that could hold lessons for other
states and the nation. It will begin to
subsidize coverage for the uninsured.
HealthRight will begin signing up
families with children in the fall and will
be fully open to Minnesota's estimated
370,000 eligible uninsured by 1994.’
Sources: New York Times 9/16/94; and Richard Reece, Medical World News 7/1/1992.
Minnesota?
small public plan option
Tennessee 1992
Gov. Ned McWherter
“Tennessee Gov. Ned McWherter unveiled a
plan April 8 for what he called ‘the most
radical health care plan in America’ and
claimed it would become the national model.
The Tennessee plan would gather nearly 1
million current Medicaid patients with 500,000
uninsured Tennesseans into a single
managed care program called TennCare.”
“TennCare is a five-year demonstration
project that will use managed care
organizations to deliver care to a million
Medicaid recipients. TennCare will cover
an additional 300,000 currently uninsured
in the first year. The number of uninsured
enrolled in the program could reach
500,000 in the second year.”
Sources: Federal & State Insurance Week 4/12/93; and PR Newswire 11/19/93.
Tennessee?
Medicaid expansion + Public Plan Option
Washington?
Mandates + Medicaid
Maine?
Public Plan Option
Massachusetts?
Medicaid and medicaid-like expansions, mandates,
+ public plan option for those <300% poverty
Most Residents of Massachusetts
Affected by Health Reform Report it is
Hurting Them
Robert J. Blendon, et al, “Massachusetts Health Reform: A Public Perspective From Debate Through
Implementation,” Health Affairs 27, no. 6 (2008): w562 (published online 28 August 2008;
10.1377/hlthaff.27.6.w556).
Most Residents of Massachusetts
Affected by Health Reform Report Higher
Health Care Costs
Robert J. Blendon, et al, “Massachusetts Health Reform: A Public Perspective From Debate Through
Implementation,” Health Affairs 27, no. 6 (2008): w562 (published online 28 August 2008;
10.1377/hlthaff.27.6.w556).
SINGLE-PAYER
What is Single Payer?
Publicly
Funded
Privately Delivered
How Single-Payer affects you!

Single-Payer will help address the primary care crisis.

Under the bill (SB 810), the Commissioner is mandated to
establish a budget to support the development and training of a
health system workforce that is sufficient to meet the health care
needs of the population.

This would include assuring that adequate numbers of primary
care providers were trained and available to maintain quality of
care standards.
Single-Payer: SB 810
Universal?
Yes.
Continuous?
Yes.
Affordable?
Yes.
Sustainable?
Yes.
Promotes access to
high quality care?
Yes.
SB 810
Guarantees comprehensive benefits

Coverage includes:
 Medical, dental and vision care.
 Prescription drug.
 Emergency room services, surgical and recuperative
care.
 Emergency and other necessary transportation.
 Orthodontia.
 Mental health care and drug rehabilitation.
 Immunizations.
 Laboratory and other diagnostic services.
 Adult day care.
 All necessary translation and interpretation.
 Case management and skilled nursing care.
Single-Payer –
Affordable
(This is important.)
SB 810 - Affordable

SAVINGS FOR FAMILIES
 Families with under $150,000 in annual income would, on
average, see savings ranging between $600 and $3,000
per family.

SAVINGS FOR BUSINESSES
 Employers who currently offer health benefits would realize
average savings of 16% compared to the current
system.
SAVING FOR STATE AND LOCAL GOVERNMENTS
 In addition, state and local governments would save about
$900 million, in the first year, in spending for health benefits
provided to state and local government workers and retirees.
Aggregate savings to state and local governments would be
about $43.8 billion over 10 years.

Source: Non-Partisan Lewin Group Report, 2005
SB 810
Saves Money

By 2015, health spending in California
under the Act would be about $68.9
billion less than currently
projected. Total savings over a ten
year period would be $343.6 billion.
Source: Non-Partisan Lewin Group Report, 2005
Single-Payer - Affordable

June, 1991 General Accounting Office:
“If the US were to shift to a system of universal
coverage and a single-payer, the savings in
administrative costs [10 percent of health
spending] would be more than enough to offset
the expense of universal coverage.”
(“Canadian Health Insurance: Lessons for the United States,” 10 pgs, ref no: T-HRD-91-35. Full text available
online at http://archive.gao.gov/d20t9/144039.pdf).
Single-Payer - Affordable

August, 2005 -The National Coalition on Health Care:
Impacts of Health Care Reform: Projections of Costs and
Savings; By Kenneth E. Thorpe, Ph.D.
This fiscal analysis of the impact of four scenarios for health
care reform found that the single payer model would
reduce costs by over $1.1 trillion over the next decade
while providing comprehensive benefits to all Americans.
The other scenarios would be improvements over the status
quo, but would not reduce costs as dramatically or provide the
same high-quality coverage to all.
Single-Payer - Affordable

December, 2007: Kansas Single-Payer would save $869
million:
The Kansas Health Policy Authority hired the consulting firm of
Schramm-Raleigh to do a fiscal analysis of five options for
expanding coverage. They found that single payer (“the
Mountain plan”) would cover all the uninsured and reduce
state health spending by $869 million annually. The other
plans would cover a portion of the uninsured and would raise
costs between $150 million to $500 million in the state.
(www.healthfund.org/reportspubs/11012007fdn_report_khpa.php)
Single-Payer - Affordable

June 2004: Single-Payer in Georgia would reduce
healthcare spending
A fiscal study by the Virginia-based Lewin Group found that
Single-Payer health would cover all Georgia residents
and save $716 million annually.
Nearly all Georgia families would pay less for health care
than they are today for much better coverage.
Source: (The Lewin Group, Inc. “The Georgia SecureCare Program: Estimated Cost and
Coverage Impacts” Final report 10/21/03) (Full text of the study available online at:
http://www.pnhp.org/news/lewinanalysis.pdf)
Single-Payer - Affordable

November 2002: Rhode Island: Single Payer would save
$270 million in Rhode Island
At first, the administrative and bulk purchasing savings have the
largest impact. But over time, slowing the rate of inflation to 4
percent has a larger impact. Over six years, they estimate that
consolidated financing alone would save $4.4 billion, while
single payer with “professionalism within a budget” delivery
system reform would save over $6.6 billion. Again, both
models of single-payer would provide coverage for all the
uninsured and improve coverage for all Rhode Islanders.
Source: (“Rhode Island Can Afford Health Care for All: A Report to the Rhode Island General
Assembly” On-line at www.healthreformprogram.org. For copies of this report, please contact
Alan Sager or Deborah Socolar or phone the Health Services Department at (617) 638-5042. )
Single-Payer - Affordable

October 2003: Missouri Single-Payer would save $1.3 billion in
Missouri
Missouri Foundation for Health conducted a study on “health care
expenditures and insurance in Missouri”:
A single payer health care plan in the state of Missouri would reduce
overall spending by about $3 billion.
“Even if the state would adopt a benefit package-one more
generous than 75 percent of all private insurance benefits in the
state-overall spending would decline.”
Source: ( “A Universal Health Care Plan for Missouri”, the full report can viewed
athttp://www.mffh.org/ShowMe3.pdf)
Single-Payer – Affordable:
So what does this mean?
For more data on affordability:
http://www.pnhp.org/facts/single_payer_system_cost.php?page=all

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The evidence is strong.
Cost directly impacts affordability for families and
individuals.
Cost directly impacts long-term sustainability for the
program as a whole.
If it isn’t affordable and
sustainable it isn’t feasible!
Feasibility –
But we’ll never get political
support…
The State Option
and the California Example
Political Support
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AFSCME District Council 36 - 5/11/09
AFSCME Local 57 – 5/1/09
AFSCME Local 444 – 5/8/09
AFSCME Local 955 – 5/6/09
AFSCME Local 2019 – 5/6/09
AFSCME Local 2428 – 5/7/09
AFSCME Retirees Chapter 36 – 3/16/09
Alameda-Contra Costa Transit District – 4/21/09
Alliance for Democracy, Mendocino Coast – 4/11/09
AP Goodyear Construction – 4/13/09
ACLU, Southern California – 4/2/09
American Association of University Women
American Association of University Women, Pasadena Branch
American Federation of State, County and Municipal Employees (AFSCME) –4/8/09
American Medical Students Association, National - 3/25/09
American Medical Students Association, Davis School of Medicine chapter -3/27/09
American Medical Students Association, UCLA Pre-medical Chapter 5/6/09
Bay Area Veterans of the Civil Rights Movement - 3/22/09
California Alliance for Retired Americans - 4/13/09
California Chiropractic Association (if amended) – 4/30/09
California Commission on the Status of Women – 4/7/09
County Health Executives Association of California – 3/26/09
Democratic Party of Contra Costa County – 5/21/09
Diablo Valley Democratic Club – 3/19/09
Political Support
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California Communities United Institute – 3/9/09
California Health Professional Student Alliance – 5/21/09
California Federation of Teachers – 4/7/09
California Foundation for Independent Living Centers – 4/24/09
California Labor Federation, AFL-CIO – 4/6/09
California Nurses Association/National Nurses Organizing Committee – 3/24/09
California Pan-Ethnic Health Network – 4/21/09
California Physicians Alliance – 4/10/09
California Professional Firefighters – 3/23/09
California Retired Teachers Association – 4/14/09
California School Employees Association – 3/20/09
California Senior Coalition – 5/25/09
California Society for Clinical Social Work - 4/9/09
California Student Physicians for Healthcare Reform – 4/10/09
California Teachers Association – 4/7/09
Church of Christ the Saviour, Orthodox Church of America, San Francisco –4/13/09
Church of St. John the Baptist, El Cerrito – 5/22/09
City of Albany – 4/13/09
City of Berkeley – 4/21/09
City of El Cerrito – 4/7/09
City of San Pablo – 3/31/09
City of Santa Monica – 4/15/09
Coalition of Lavender-Americans on Smoking and Health (CLASH) – 5/7/09
Coastside Democrats – 5/24/09
Committees of Correspondence – 3/31/09
Concerned Citizens of Laguna Woods Village 5/15/09
Consumer Federation of California – 3/25/09
Contra Costa County Advisory Council on Aging – 5/22/09
Political Support
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East Bay Peace Action – 5/26/09
Easter Hill United Methodist Church – 3/31/09
El Cerrito Democratic Club – 4/7/09
Elsdon, Inc., small business – 4/2/09
Evergreen Democratic Club – 5/8/09
Federation of Retired Union Members of Santa Clara County – 4/15/09
Glendale City Employees Association – 4/1/09
Having Our Say – 4/8/09
Health Access of California – 3/24/09
Health Care for All – California – 3/9/09
Health Officers Association of California – 4/29/09
Hubert Humphrey Democratic Club – 5/4/09
International Alliance Theatrical Stage Employees Local 33 – 4/19/09
International Association of Machinists – 4/9/09
The Kennedy Club of San Joaquin – 4/5/09
Labor Task Force for Universal Health Care - 4/20/09
Lamorinda Peace and Justice Group – 4/3/09
League of Women Voters, Diablo Valley – 4/13/09
League of Women Voters, El Dorado County – 4/3/09
Leagues of Women Voters, Oakland - 5/12/09
League of Women Voters, San Diego County – 4/21/09
League of Women Voters, San Joaquin County – 4/1/09
League of Women Voters, San Jose/Santa Clara -4/1/09
League of Women Voters, Southwest Santa Clara Valley – 5/6/09
Political Support
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Los Angeles Unified School District – 4/8/09
Lumina Media Productions (Richmond, CA) – 3/4/09
Manteca Democratic Club – 3/9/09
Marin County Board of Supervisors – 4/20/09
National Association of Social Workers, California chapter – 4/23/09
National Council of Jewish Women, Long Beach – 4/12/09
North Richmond Municipal Advisory Council – 5/12/09
Officescapes, Newport Beach, CA – 4/11/09
Old Lesbians Organizing for Change – 4/12/09
Older Women’s League of California – 4/13/09
Older Women’s League – San Francisco Chapter - 1/13/09
Organization of SMUD Employees – 4/1/09
Promotores de Salud of Behavioral Health Services 5/13/09
Rainbow Coalition, West Contra Costa – 3/24/09
Richmond Commission on Aging 12/5/08
San Bernardino Public Employees Association – 4/1/09
San Fernando Valley Interfaith Council – 3/18/09
San Francisco Tobacco Free Coalition – 5/4/09
San Jose Peace and Justice Center – 4/29/09
San Luis Obispo County Employees Association – 4/1/09
Santa Monica Community College District – 5/4/09
Santa Rosa City Employees Association – 4/1/09
Service Employees International Union – 4/7/09
St. John of God Catholic Church, San Francisco – 4/8/09
Students of University of CA Program in Medical Education (PRIME) – 3/1/09
Political Support – Just the Co-Authors!
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Elaine Alquist (principal)
Gil Cedillo
Ellen Corbett
Mark DeSaulnier
Dean Florez
Loni Hancock
Alan Lowenthal
Alex Padilla
Fran Pavley
Gloria Romero
Darrell Steinberg
Patricia Wiggins
Leland Yee
District 13
District 22
District 10
District 7
District 16
District 9
District 27
District 20
District 23
District 24
District 6
District 2
District 8
San Jose
Los Angeles
San Leandro
Walnut Creek
Bakersfield, Fresno
Oakland
Long Beach
Van Nuys
Santa Monica
Los Angeles
Sacramento
Santa Rosa
San Francisco
Political Support – Just the Co-Authors!
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Tom Ammiano
Karen Bass
Jim Beall
Marty Block
Bob Blumenfield
Julia Brownley
Wes Chesbro
Joe Coto
Mike Davis
Hector De La Torre
Mike Eng
Noreen Evans
Mike Feuer
Mary Hayashi
Jared Huffman
Dave Jones
District 13
District 47
District 24
District 78
District 40
District 41
District 1
District 23
District 48
District 50
District 49
District 7
District 42
District 18
District 6
District 9
San Francisco
Los Angeles
San Jose
Lemon Grove
Van Nuys
Woodland Hills
Eureka, Santa Rosa, Ukiah
San Jose
Los Angeles
South Gate
Monterey Park
Santa Rosa, Napa, Vallejo
West Hollywood
Hayward
San Rafael, Santa Rosa
Sacramento
Political Support – Just the Co-Authors!
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Ted Lieu
Bonnie Lowenthal
Fiona Ma
Tony Mendoza
Pedro Nava
Curren Price
Ira Ruskin
Mary Salas
Nancy Skinner
Jose Solorio
Sandré Swanson
Tom Torlakson
Alberto Torrico
Mariko Yamada
District 53
District 54
District 12
District 56
District 35
District 51
District 21
District 79
District 14
District 69
District 16
District 11
District 20
District 8
El Segundo
Long Beach
San Francisco
Norwalk
Santa Barbara, Oxnard
Inglewood
Los Altos
Chula Vista
Oakland
Anaheim
Oakland
Martinez
Fremont
Vacaville
Taking
Action.
Your support matters!

Educate.

Educate yourself:
• http://www.PNHP.org/news/
• http://healthreform.kff.org/

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Educate others: Help me get speakers to other
residency programs!
Advocate.

Contact your State Senator for Floor Vote Tomorrow!
• Find your Senator: votesmart.org

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Join our OC Leg visit team
Grow.
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Help improve the PNHP LA Chapter
Help develop the District Leader Network
Join PNHP!
Questions?
 How
this affects you!
 The problem.
 Potential solutions.
 Common concerns.
 Taking action.
THANK YOU!
CaPA.Fellow@PNHP.org
www.PNHP.org
EXTRA SLIDES
How this affects
you!
How reform affects you!

Healthcare reform will dramatically
change how we practice medicine.

We have a responsibility to defend our
patients and our professions; if we don’t
take the lead then others will!
How Single-Payer affects you!

Single-Payer will help address the primary care crisis.

Under the bill (SB 810), the Commissioner is mandated to
establish a budget to support the development and training of a
health system workforce that is sufficient to meet the health care
needs of the population.

This would include assuring that adequate numbers of primary
care providers were trained and available to maintain quality of
care standards.
How Single-Payer affects you!

Single-Payer will eliminate the role of
insurance companies in making healthcare
decisions. Decision making will be returned
to healthcare providers and their patients.

Single-Payer would end uncompensated
medical care by guaranteeing everyone has
access to a payer.
The Uninsured
Source: Fronstin, Paul. 2002. Sources of Health Insurance: Analysis of the
March 2002 Current Population Survey. Issue Brief 252. Washington, DC:
Employee Benefit Research Institute; Mills, Robert, and Bhandari, Shailesh.
2003. Health Insurance Coverage in the United States: 2002. P60-223.
Washington, DC: U.S. Census Bureau.
 And
who will financial
hardship effect
disproportionately?! …
The Problem.
 Poor
Outcomes.
 The Uninsured.
 The Underinsured.
 High Costs.
Inequality.
Racial Disparity in Access to
Kidney Transplants
Vermont?
Oregon?
Mandates + Medicaid expansion
Massachusetts 2006,
Medicaid and medicaid-like expansions,
mandates, + public plan option for those
<300% poverty
“Every uninsured citizen in
Massachusetts will soon have affordable
health insurance and the costs of health
care will be reduced.
Gov. Romney.”
“The bill does what health experts
say no other state has been able
to do: provide a mechanism for all
of its citizens to obtain health
insurance.”
Sources: Wall Street Journal 4/11/06 and New York Times 4/5/06.
“You Can’t Cross a Chasm in Small
Steps” – David Lloyd George
Single-Payer - Affordable

December 2002: Maine Single-Payer an
economically feasible option for
Maine.
“In summary, a single-payer system
appears to be economically feasible for
Maine.”
Source: (Mathematica Policy Research, Inc, “Feasibility of a Single-Payer Health Plan Model for the State of
Maine” Final report 12/24/03/, MPR Ref No: 8889-300, 80 pages.http://www.mathematicampr.com/PDFs/mainefeasibility.pdf)
But, but, but…
This just isn’t feasible!...
Feasibility –
But healthcare providers will
never support this…
Feasibility –
But other people will never
support this…
The Uninsured
More than 80%
of uninsured children and adults
live in working families.
More than 80%
are US citizens.
•Kaiser Family Foundation, 2004
Common
Fears.
Common Fears.

Fear #1:


Fear #2:


Socialized medicine and increased taxes
Rationing and long waiting times
Fear #3:

It will ruin our system
Fear #1:
Socialized medicine and taxes

TRUTH: It’s cheaper!
Total Health Expenditure per Capita in US $
7000
TRUTH: It Guarantees
choice!
Under SB 810, all
consumers have complete
freedom to choose their
healthcare providers. No
more restrictive HMO
networks. Delivery of care
remains as it is; a
competitive mix of public
and private providers.
6000
5000
US $

2003
4000
2004
3000
2005
2000
1000
0
Canada
France
Germany
Japan
Sweden
Major Industrial Countires
Source: OECD, 2006
United
Kingdom
United
States
Fear #2:
Rationing and wait times

TRUTH: We already have rationing and wait times!

TRUTH: SB 810 has specific provisions to insure that the
demand for healthcare providers and resources is met in
a comprehensive and systematic manner.
Source: Business Week, June 2007; Commonwealth Fund;
Fear #3:
It will ruin our system
Quality of Care Slightly Better in Canada Than U.S.
A Meta-Analysis of Patients Treated for Same Illnesses
(U.S. Studies Included Mostly Insured Patients)
Source: Guyatt et al, Open Medicine, April 19, 2007
Variation in Medicare Spending:
Some Regions Already Spend at Canadian Level
Public Program Extension and Tax
Credit
Universal?
No.
Continuous?
Gaps in coverage.
Affordable?
Somewhat.
Sustainable?
Not during difficult
economic times.
Similar to status quo.
Promotes access to
high quality care?
Individual Mandate and Tax
Credit
Universal?
Unlikely.
Continuous?
Brief gaps.
Affordable?
Not for the older, less
healthy, and those in
expensive areas.
Unlikely.
Sustainable?
Promotes access to high Similar to status quo.
quality care?
SB 810
Security - Everyone is covered
Choice - Everyone can choose their doctors and other providers.
Health care delivery is in the private sector.
Comprehensive Benefits - Everyone has full benefits.
High Quality - Doctors and patients, not administrators, make
medical decisions.
Efficient Administration - Huge savings result from removing
insurance companies from health care. Provider and patient paper
work is slashed.
Fair Reimbursement - Providers receive fair and full compensation
for their services.