HEALTHCARE 101
-by Nancy Kivlen
Statistics are the best argument for understanding why the United States needs to improve our healthcare system. If we continue down the path that we're on, healthcare will simply become unsustainable.
According to a Kaiser Permanente Foundation study, healthcare premiums in the U.S. have risen 78% since 2001. Drug costs are increasing at a rate of 8% a year, the number of uninsured Americans rose from 44 million to 47 million in one year (a 7% increase) and the number of uninsured children increased 12% in one year.
For those Americans that are insured through their employers, many companies are passing the higher premium costs back to their employees, or choosing not to offer healthcare insurance at all. Other costs such as co-payments, deductables and perscription drug costs are all increasing at a rate much higher than inflation and wages.
It is not surprising to learn that 1.46 million Americans that filed for bankruptcy in the U.S. last year cited medical causes as the main reason. Even more shocking is that 76% of these people actually had health insurance when they filed for bankruptcy. In 1996, this figure was 312,000 bankruptcies due to medical causes, a 379% jump to 1.46 million in 2006.
The United States currently spends over $2 trillion per year on healthcare, more than any other country in the world and at the current rate of spending, this will double to $4 trillion in just 9 years.
Consider these increases in escalating healthcare costs as tax increases. They are imposed on us by the Insurance and Pharmaceutical companies that have little oversight into the record profits they are earning. Yet our "tax" increases have not bought us better healthcare, instead we have less benefits, less affordability and less availability.
The United States has fallen far behind other industrialized nations in terms of the overall healthcare we provide to our citizens, in particular with regards to affordability and availabilty.
The World Health Organization did a comparison study on how countries around the world stack up against each other with regards to healthcare. The United States ranked 37th, the lowest ranking of industrialized nations in the world.
France ranked #1, Italy #2, then several small European countries, #6 Singapore, #7 Spain, #8 Oman, #9 Austria, #10 Japan, #11 Norway, #12 Portugal, #13, Monaco, #14 Greece, then other smaller countries in Europe, #18 Great Britain, #19 Ireland, #33 Columbia, #24 Cyprus, #25 Germany, #26 Saudia Arabia. Israel was #28, Morrocco #29, Canada #30, Chile #33, Costa Rica #36, United States #37, Slovenia #38, and Cuba #39.
The World Health Organization considered many factors to determine the overall rankings:
1.) Good Health - is the overall health of the country as good as possible? This is judged primarily through life expectancy statistics which encompasses the number of healthy years on average for that nation's population, and infant mortality rates. This is the number of deaths per 1,000 live births. Shockingly, the U.S. has the highest number of infant mortality rates for an advanced nation.
2.) Cost - the overall cost of the nation's healthcare. The U.S. is last as we have the highest costs and pay the most for healthcare.
3.) Fairness and Distribution - Is the burden of healthcare costs fairly distributed based on ability to pay so that everyone is equally protected from financial risks due to illness? Again the U.S. ranks last in this area, we are the only developed nation that does not protect it's citizens from financial health risks and provide health care to all our citizens.
4.) Responsiveness - in this area the U.S. ranks #1. That is the extent to which caregivers are responsive to patients needs.
This chart compares seven of the major industrialized countries:
| Country | Life Expectancy | Infant Motality | Per Capita Expenditure | Healthcare costs as % of GDP | Fairness in Financial Contribution | Doctors & Nurses per 1,000 people | Responsiveness | % of Satisfaction | WHO ranking overall performance |
| United States | 77.5 | 7.2 | $5,711 | 15.2% | 54.5 | 5.97 | # 1 | 40% | # 37 |
| Great Britain | 79.5 | 5.9 | $2,428 | 8.0% | 9.5 | 7.21 | #26 | 57% | # 20 |
| France | 79.5 | 4.6 | $2,981 | 10.10% | 27.5 | 5.31 | #16 | 65% | # 1 |
| Germany | 80.0 | 4.9 | $3,204 | 11.10% | 6.5 | 6.55 | # 5 | 58% | # 25 |
| Canada | 80.5 | 5.2 | $2,669 | 9.90% | 18 | 6.05 | # 7 | 46% | # 30 |
| Australia | 80.5 | 5.2 | $2,519 | 9.5% | 27.5 | 6.09 | #12 | N/A | # 32 |
| Japan | 82.5 | 4.0 | $2,662 | 7.9% | 9.5 | 4.89 | # 6 | N/A | # 10 |
| Average | 80 | 5.3 | $3,168 | 10.24% | 21.8 | 6.01 | N/A | 53% | N/A |
Of these 7 major countries, the U.S. has the lowest life expectancy and the highest infant mortality rate. We pay the highest amount for healthcare per capita, 78% more than the 2nd highest, Germany. We pay the highest healthcare costs as a percentage of our gross domestic product at 15.2%, yet we are the least satisfied with our system - 60% of Americans are dissatisfied. We received the lowest rating in terms of financial fairness, that is because so many of our citizens do not have access to the system because they are uninsured. One reason the U.S. ranking isn't lower than 37th is because we were #1 in responsiveness to patients needs.
Understanding the differences between Socialized, Nationalized, and Universal Healthcare
Socialized Medicine is provided in both Sweden and Great Britain. This is where the doctors are salaried civil servants, the Government owns and operates most of the hospitals. Currently, in the United States, the Veterans Administration would be similar. The VA runs the hospitals and and the costs are paid for by U.S. taxpayers.
Nationalized Healthcare is what Canada has. It is a single payer Insurance plan, Doctors are in private practice and most hospitals are not Government owned. In the United States, Medicare, and Medicaid are all covered through national healthcare paid by U.S. taxpayers. You can choose your own doctor as long as they accept Medicare and/or Medicaid Insurance.
Universal Heatlhcare (Hillary's plan) means that it is Universal Healthcare offered to all U.S. citizens through private and government funded (like Medicare) insurance companies. This is not a government run system. But it is a way to cover all U.S. citizens with health insurance and eliminate the financial burden for the 47 million uninsured citizens. This is also the system that France has (ranked #1). France has delivered good results through a combination of both public and private financing.
The Basics of Hillary's American Health Choices Plan
*Insurance coverage for all Americans
- keep your current coverage through your employer or private plan if you want to
- if you don't have healthcare, or want to change - you can either
a.) choose from the same private healthcare plan that congress enjoys, or
b.) choose a quality public plan similar to Medicare
*Affordable - because the plan provides tax credits for Americans to help cover costs of premiums. These tax credits ensure that working families never have to pay more than a limited percentage of their income for health care.
*Availabilty - Insurance companies will not be allowed to deny coverage to anyone with a pre-existing condition.
*Portability - If you chose to or lose your job, you keep your healthcare.
*Good for Businesses - the plan offers tax credits to small businesses that provide health care to their workers to help defray their costs. It allows small businesses to compete and create jobs with health benefits, if the company is based in the U.S.
*Reins in Insurance Companies - they can no longer deny coverage, they have to offer and renew coverage for anyone who applies. Insurance companies will need to compete for your business based on quality and price. If a person becomes ill or loses their job, they will have the security of knowing they won't lose their coverage.
Lowering Healthcare Costs
*Providers will use privacy protected information technology - this gives doctors financial incentives to adopt health information techonolgy. It aligns medicare payments with performance and reduces geographic variations in care. It provides patients with information through databases. It reduces medical billing errors and overpayments.
*Phase out medicare overpayments to HMOs and other managed care plans - policies to improve access to programs that provide cost sharing protections.
*Purchasing leverage to reduce prescription drug costs - Medicare and others will negotiate lower drug prices and create a pathway for generic drug competiion by removing barriers and providing oversight of pharmaceutical companies financial relationships with providers.
*Reform Medical malpractice that works for doctors and patients through programs that have already worked, such as the Medical Error and Disclosure Act adopted by Univ of Michigan Hospital system.
*Prioritize prevention - only half of recommended clinical preventative services are provided to adults with regards to weight, nutrition, or exercise. Heart disease and diabetes still account for 75% of our total national health expenditures and are the leading causes of death in the U.S.
Total Federal Savings from reducing overpayments and new efficiencies: $56 billion
*New tax credits will make health insurance affordable for working families. These tax credits will be financed by redireting tax breaks and closing current tax loopholes:
*Roll back of Bush Tax cuts for the top 2% income tax brackets and Bush increases in tax exempeptions for households earning over $250,000 per year.
*Cap federal income tax exclusion of employer contributions for health benefits for households earning over $250,000 per year.
Total tax savings from limits on High-Income Tax Breaks: $54 billion
Total Savings / Reinvestment: $110 billion
Why Hillary's plan is good medicine for America
*The American Health Choices Plan does NOT raise taxes. It simply rolls back Bush tax cuts for those earning over $250,000 per year. So, if you earn over $250,000 per year, your taxes will go back to what they were in 2000.
*Hillary's plan is not "Government Run" - everyone that is happy with their current plan, stays with their current plan.
*Hillary's plan will REDUCE costs in wasteful spending, for insurance premiums, Small Businesses, and Prescription Drugs.
here is a link to the summary of the American Health Choices Plan:
http://www.hillaryclinton.com/feature/healthcareplan/summary.aspx
here is a link to a detailed pdf of the plan:
http://www.hillaryclinton.com/feature/healthcareplan/americanhealthchoicesplan.pdf
*Hillary has been involved in healthcare studies since 1973 when she did post graduate work on Children and Medicine at Yale. As First Lady of Arkansas, she was on the boad of Children's Hospital and chaired a Rural Health Advisory Board. When she was First Lady, she was unsuccessful in getting her healthcare plan passed through Congress in the 90's, but as she states, she learned a lot. She was successful, however, in getting healthcare programs passed for children.
Take a look at some of the reviews about her current American Health Choices Plan:
http://www.hillaryclinton.com/blog/view/?id=13333
10 reasons why the Republican Healthcare Plans won't help Americans
1.) They are focused primarily on tax breaks that have a cap.
2.) They do not address the problem of the 47 million uninsured Americans that currently cannot get Insurance.
3.) They do not address the problem of escalating prescription drug costs.
4.) They do not allow Medicare to negotiate directly with drug companies for lower prices.
5.) They do not clear the pathway for generic drugs to become available more quickly.
6.) They do not address the skyrocketing healthcare costs.
7.) They do not rein in Insurance companies with regards to pre-existing conditions or denying coverage
8.) They do not address portability of your insurance plan.
9.) Congress will still get the great plan they have, while middle-class Americans are "stuck" with more of the same.
10.) Nothing Changes - your medical costs will continue to rise.
HILLARY'S PLAN IS A PLAN FOR ALL AMERICANS
THE REPUBLICAN PLAN IS A TAX BREAK FOR THOSE THAT QUALIFY
One point that you did not mention is that Hillary's plan mandates everyone buy insurance and I'm not sure how that will work. But I do agree with you, it's better than what the other side is offering.
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It's interesting that you did not bring up a comparison to Obama and Edwards' plans. I do think Hillary has the most comprehensive and I don't trust Edwards since he made his millions on medical malpractice lawsuits. Obama's plan does not require the mandate that Hillary's does - her plan goes further, but stops short of single pay insurance.
read this great arcticle in the huffington post by Dr. Blumenthal for comparisons of all the plans:
http://www.huffingtonpost.com/susan-blumenthal/us-presidential-candida_b_55460.html
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