Health Care. Is it a Legal Right No –Not Mentioned in the Constitution –Not wanted by the States –It therefore belongs to the people We view it, however,

Health Care

Is it a Legal Right

• No– Not Mentioned in the Constitution

– Not wanted by the States

– It therefore belongs to the people

• We view it, however, as a right

Health Care Has Multiple Goals

• Being Healthy

• Living a Long Life

• Having Good Medical Care

• Making sure Everyone has this

These goals make policy difficult

How Much do We Spend

• 2.2 Trillion Dollars

• 8000 Per person

• 16.2% of the GDP

A Hybrid System of Public and Private

• Modern Health Care is a product of the 1930’s.

• 46% is paid for by the government

• The Rest is from employers, and individuals

Where the Money Comes From

What the Government Covers

• Medicaid

• Medicare

• SCHIP

• Veterans Administration

• Government Employees

Medicaid

• Health Care as Welfare

• Single Largest Welfare program for the poor

• Fraught with problems

Medicare

• Health Care for Seniors

• How it works

Medicare

• Non-Means Tested

• Increasingly Expensive

• Fraught with Problems

Private Insurance

• Fee For Service

• Managed Care- 90% of all private insurance

SCHIP

• Health Care for Children on the Bubble

• Increasingly Expensive

Terms of Health Care

• Premium

• Deductable

• Copayment

How We Get our Health Care

Strengths of the System

• Best Doctors and Hospitals

• Most Advanced Treatment

• Most Research and Development

• People with Health Care are satisfied With it.

The Problems of the System

• Access

• Cost

• Quality

The Problem of Access

The Problem of Access

• It is not “46 Million Americans”, but 46 Million in America

The Problem of Access

The Problem of Access

The Problem of Access

Why People do not have insurance

• Who are they?

• Health Care is an opportunity cost

Options for the Uninsured

• E.R.

• Self Medicate

• Do Nothing

Problem 2 Quality

• Quality is maldistributed

• We focus on sickness, not health

• We are overspecialized

Problem 3: Cost

• Outpacing Inflation

• Why

Cost- Technology

• MRI’s

• Bypass surgery

• Fake Knees and Hips

• These help us live longer

Cost- Labor

• 5.5 People per patient

• Jobs that require skill and education

• Recession Proof

Cost- Malpractice

• Actually not the law-suits themselves

• Defensive medicine

• High Insurance- just in case

Cost- Greedy people

• We want to get our benefits back

• We do not realize the actual costs

• A “Tragedy of the Commons”

Cost- An Older Population

• Our last years of life consume much of our health care dollar

• We are living longer and there are more of us

• More Care means more $

Cost and Prescription Drugs

• Average cost is $2400

• 9 in 10 Seniors use a drug

• Direct to Consumer Ads

Health Care Reform

• Insuring more people by changing the number

• The 46-47 Million number is gone

Expanding Federal Programs

• Getting those eligible on programs they are eligible for– Expanding Medicare Eligibility– Expanding COBRA health insurance– Expanding SCHIP Program

Making Changes to Private Insurance

• Cannot Deny for Pre-Existing Conditions

• Cannot remove people who use up their coverage

• The Slackers mandate

• Subsidies to purchase insurance

Individual Mandates

• People will be required to have health insurance– Just as we are required to have health

insurance

• This is the tricky part

What if I have Insurance

• In theory it should not change

• Your employer, however, can just you off

When does it start

• Mandates begin in 2014

• Costs should be lowered over time as people have insurance

How can we afford this

• 1 Trillion over first 10 years– Tax on Tans – Higher medicare taxes on wealthy and

Medicare cuts– Taxes on High-end insurance– Fees on Health Care Industry