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"Of all the forms of inequality, injustice in health care is the most shocking and most inhumane"

"Of all the forms of inequality, injustice in health care is the most shocking and most inhumane". Martin Luther King Jr (March 25, 1966, National Convention of the Medical Committee for Human Rights, Chicago). HEALTH CARE SECURITY FOR ALL. A moral, ethical, social & religious good

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"Of all the forms of inequality, injustice in health care is the most shocking and most inhumane"

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  1. "Of all the forms of inequality, injustice in health care is the most shocking and most inhumane" Martin Luther King Jr(March 25, 1966, National Convention of the Medical Committee for Human Rights, Chicago)

  2. HEALTH CARE SECURITY FOR ALL • A moral, ethical, social & religious good • A family value • An economic necessity

  3. 46+ Million Uninsuredand Rising

  4. COSTS SOARING TWO TRILLION DOLLARS AND STILL RISING 15% OF GNP

  5. 18,314 Adult Deaths Annually Due to Uninsurance

  6. Illness and Medical Costs,A Major Cause of Bankruptcy • Over 50% of all bankruptcies involve a medical reason or large medical debt • 326,441 families identified illness/injury as the main reason for bankruptcy in 1999 • An additional 269,757 had large medical debts at time of bankruptcy • 7 per 1000 single women, and 5 per 1000 men suffered medical-related bankruptcy in 1999 Source: Norton's Bankruptcy Advisor, May, 2000

  7. Who Pays for Nursing Home Care? Source: Health Affairs 2000; 19(3):44

  8. Children • 25% • Unemployed • 5% • *Out of labor • force • Employed • 20% • 50% Who Are The Uninsured? *Students>18, Homemakers, Disabled, Early retirees Source: Himmelstein & Woolhandler - Tabulation from 1999 CPS

  9. The Eight Americas • 1. Asians, • 2. Northland low-income rural whites, • 3. Middle America, • 4. Low-income whites in Appalachia and the Mississippi Valley, • 5. Western Native Americans, • 6. Black Middle America, • 7. Low-income southern rural blacks • 8. High-risk urban blacks

  10. Disparities in mortality across the eight Americas are enormous by all international standards. Policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US. Health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries.

  11. Probability of death between the ages of 15 and 59 years in the eight Americas from all causes.

  12. Chronically Ill and Uninsured

  13. Netherlands 6% France 8% Sweden 9% Canada 11% UK 11% Germany 11% US 17% 0% 5% 10% 15% 20% % of Population Below Poverty Level Poverty Rates, 1997U.S. and Other Industrialized Nations Source: Luxembourg Income Study Working PapersNote: U.S. figure for 1997, other nations most recent available year

  14. 83 82.5 82 81.7 81.6 82 80.7 81 79.8 YEARS 80 79.4 79 78 77 U.S. U.K. ITALY CANADA FRANCE SWEDEN GERMANY Life Expectancy For Women, 1999 Source: OECD, 2002 - Data on Italy are for 1998

  15. Why Women Delay Prenatal CareWhen They Know They Are Pregnant Note: 11.1% of pregnant women failed to get timely prenatal care despite knowing they were pregnant Source: MMWR 5/12/2000; 49:393

  16. Health Care Administrative Costs in the U.S. Administrative Costs 31% Clinical Care 69% $7 billion of the WI healthcare dollar is spent on administration New England Journal of Medicine 8/03

  17. Health Care Financing Today • The financing of health care is really a shell game with all the payers trying to avoid paying the fixed costs of health care

  18. Cost shifting: No end in Sight Deficit Cost shift Higher premiums Bills not paid Fixed costs of healthcare services not met More uninsured More underinsured Get Care

  19. CEO Firm Pay (mill) Stock (mil) Wilson Taylor Cigna $5.0 $64.2 Norman Payson Oxford $3.3 $44.7 Leonard Shaeffer Wellpoint $2.2 $45.5 Richard Huber Aetna $2.2 $21.3 William McGuire United Hlthcr. $1.5 $87.8 Melvin Goodes Warner Lambert $16.5 $287 Paul Ormond Manor Care $7.8 $43.7 Peter Nicholas Boston Scientific $0.8 $1198 Thomas Frist Jr. Columbia/HCA $.025 $445 CEO Pay and Stockholdings, 1998 Source: Jenks Healthcare Business Report 7/24/99

  20. Employers’ Health Benefit Costs US vs. Canada

  21. Drug Companies’ Cost Structure

  22. 100% 100% 100% 100% 100% 100% 92% 80% 60% 45% 40% 20% 0% U.S. Germany France Canada Australia Japan U.K. Percent of Population withGovernment-Assured Insurance Note: Germany does not require coverage for high-income persons, but virtually all buy coverageSource: OECD, 2002 - Data are for 2000 or most recent year available

  23. Who’s paying the Health Care bill? Individuals 20% 60% taxpayers 20% {Medicare, Medicaid. Public employees, tax subsidies} Private employers In the end, we all pay the total bill, but we all don’t have coverage for our own care Source: NEJM 1999; 340:109; Health Affairs 2000; 19(3):150

  24. We have the brains, resources and ability to resolve these problems so let’s do it.

  25. THREE PROPOSALS • WICONSIN HEALTH PLAN • WISCONSIN HEALTH CARE PARTNERSHIP PLAN • WISCONSIN HEALTH SECURITY ACT

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