Planning Committee in Boston for a Single-Payer System in Vermont Happy New Year everyone! Recently, there's been a buzz in the Boston Globe about VT having the chance to form a state wide single-payer system. Peter Shumlin, a single-payer supporting governor won the election and is leading an effort to get single-payer. Physicians and single-payer advocates in VT have asked that medical and health professional students come to VT to show our support. So....we're organizing a trip to show our support in Montpelier, VT at 1 pm on March 26th. We're expecting Senator Bernie Sanders, Gov. Shumlin, and hopefully Howard Dean at the big event. The goal is to get 100 people from the area medical and health professional schools to trek up. Come help make this happen. We'll start planning over brunch this Saturday. Information about where and when is below. Just let me know if you'll be able to make it, so I know how much food to make. Please pass this along to other individual people --- medical students, nursing students, social work students, public health students etc who you think would be interested in spearheading a group to join us. Onward, Sim VT Action Planning Meeting 11 AM Saturday, January 8th 36 Goodrich Rd. Apt. 1 --- at the end of the block Jamaica Plain, Boston BUS: Right off the 39 Bus line (get off at Lakeville Rd and walk one block further to Goodrich) Train: Or, take the orange line to Green St. Left out of the station on to Green St. Take a right on Centre St. Left on Goodrich. Email simeon.kimmel [at] gmail [dot] com if you are interested in attending or have any questions.
Planning Committee in Boston for a Single-Payer System in Vermont Happy New Year everyone! Recently, there's been a buzz in the Boston Globe about VT having.
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Planning Committee in Boston for a Single-Payer System in Vermont
Happy New Year everyone!
Recently, there's been a buzz in the Boston Globe about VT having the chance to form a state wide single-payer system. Peter Shumlin, a single-payer supporting governor won the election and is leading an effort to get single-payer. Physicians and single-payer advocates in VT have asked that medical and health professional students come to VT to show our support. So....we're organizing a trip to show our support in Montpelier, VT at 1 pm on March 26th. We're expecting Senator Bernie Sanders, Gov. Shumlin, and hopefully Howard Dean at the big event. The goal is to get 100 people from the area medical and health professional schools to trek up.
Come help make this happen. We'll start planning over brunch this Saturday. Information about where and when is below. Just let me know if you'll be able to make it, so I know how much food to make. Please pass this along to other individual people --- medical students, nursing students, social work students, public health students etc who you think would be interested in spearheading a group to join us.
Onward,
Sim
VT Action Planning Meeting
11 AM Saturday, January 8th36 Goodrich Rd. Apt. 1 --- at the end of the blockJamaica Plain, Boston
BUS: Right off the 39 Bus line (get off at Lakeville Rd and walk one block further to Goodrich)Train: Or, take the orange line to Green St. Left out of the station on to Green St. Take a right on Centre St. Left on Goodrich.
Email simeon.kimmel [at] gmail [dot] com if you are interested in attending or have any questions.
Pillars of medical ethics
Beneficence: Do what is good, what is needed
Nonmaleficence: Don’t do harm
Autonomy: Respect a patient’s choice
Justice: Do what is right, what is just
Pillars of medical ethics: crumbling?!
Beneficence: Do what is good, what is needed Doctors can’t afford to treat everyone
Nonmaleficence: Don’t do harm It’s hard not to do harm when you can’t treat patients
Autonomy: Respect a patient’s choice Insurance status limits treatment options, choice of
provider
Justice: Do what is right, what is just Difficult in our current system
Our whole system is crumbling
New Figures?
In 2009:
50.7 million uninsured That’s 16.7% of all Americans
Source: U.S. Census Bureau http://www.census.gov/newsroom/releases/archives/income_wealth/cb10-144.html
Our whole system is crumbling
Our whole system is crumbling
Our whole system is crumbling
Our whole system is crumbling
There must be a better way…
There must be a better way…
There must be a better way…
Source: American Family Physician, November 15, 2005
Today
There must be a better way…
Will premiums surpass income??
There must be a better way…
What is single payer?
“Expanded and improved medicare for all”Everybody in, nobody outAll necessary medical careOption to buy supplementary insuranceChoose any provider, any medical centerProgressively funded through payroll or income
taxation With current national spending, we could cover everyone
for all necessary careThis is not a radical idea – many Western
countries have something similar Generally with better health outcomes than we have!
Canadian Physicians’ Incomes 2004/2005
Specialty Annual Income
Family Medicine $202,219
Internal Medicine $284,641
Pediatrics $186,040
Psychiatry $152,916
Dermatology $311,507
Ob/GYN $334,016
General Surgery $323,639
Thoracic Surgery $463,880
Ophthalmology $436,488
All Physicians $233,617
Source: Canadian Institute for Health Information
And don’t worry, salaries are comparable!
Advantages of single payer for patients
All necessary care is paid forEveryone gets the same benefitsChoose any doctorNever lose your coverageEnjoy preventive care before getting sickPay the same or less for better care in a
better system
Advantages of single payer for doctors
Gain the ability to care for everyone Social justice – fight disparities
Do less paperwork One payer, not hundreds
See the end of insurance company claim denials!
Practice in a friendlier litigation climateGet a real health system in place
Structures in place for mandating electronic records Enabling health database research All patients with equal access to primary care
Advantages of single payer for doctors
Practice in a system with a sound structure
Advantages of single payer for the budget
Cover everyone for less than we are currently paying
Advantages of single payer for everyone
Everybody in, nobody out
http://sebchang.blogspot.com/2010/09/manon-in-black-white.html
MEDICAL STUDENTS @ PHYSICIANS FOR A NATIONAL HEALTH PROGRAM
JANUARY, 2011
What’s the situation in Vermont ?
Vermont… not just Maple Syrup!
http://upload.wikimedia.org/wikipedia/commons/thumb/d/d1/Map_of_USA_VT.svg/2000px-Map_of_USA_VT.svg.png
Vermont: Background
Long tradition of independent thought Bernie Sanders (I-VT Senator) is a long-time supporter
Authored the Senate single payer bill
The stars aligned… Governor Shumlin ran on a single payer platform Other legislators (Welch, Leahy) support single payer After ACA’s passage, health reform is still on
everyone’s minds
Vermont in early 2011
William Hsiao, Harvard Economist: To provide Vermonters with 3 state health reform
options: 1. Single payer 2. Public option 3. Plan of Hsiao’s choice
“a viable and practical single payer plan”
Who is William Hsiao?
Born in China, emigrated to NYC as a child Worked for predecessor to CIGNA Chief Actuary of the Social Security Administration in
1960’s Helped design the Resource-Based Relative Value Scale Professor of Economics at Harvard School of Public
Health Key player in designing Taiwan’s single payer system Memberships
National Academy of Sciences Institute of Medicine Society of Actuaries National Academy of Social Insurance
Why not go with a public option?
Adverse selection. Only those who can’t find affordable insurance will
buy in Cherry-picking by private companies
These are high risk patients that are expensive to insure
Public option rates skyrocket to keep up with costs The public option becomes unaffordable to everyone
Lack of administrative savings. Makes expanded coverage unaffordable
Another plan…
A new creation of William Hsiao’s?
?
The best path:
Single payer Hsiao already helped create Taiwan’s single payer
system Incredibly successful
In 1995,• 41% of population uninsured• 4.8% of GDP spent on healthcare
Now,• National health insurance• 6.1% of GDP spent on healthcare (2009)
The US is not Taiwan However, those are stunning results!
Source: Cheng, T. (2009). Lessons from Taiwan's universal national health insurance: A conversation with taiwan's health minister ching-chuan yeh. Health Affairs, 28(4), 1035-1044.
Call to action!!
Come to Vermont to meet with legislatorsOne day, and one day only!
A Saturday in March 2011 (date TBA)Show your enthusiasm for practicing in a
single payer system Rally for social justice in health care Meet doctors passionate about healthcare for all Hang out with like-minded students Optional: declare your intention to move to Vermont if
single payer is enacted Afterparty??
Can’t come? Sign our statement!
A quick and easy way to show your support
“We support a universal health care system for the State of Vermont, one that includes all Vermonters, offers free choice of providers, is progressively financed, decoupled from employment, affordable for all, and pays for all necessary care out of public funds; a system which retains the private delivery of health care and has a publicly accountable budget process to ensure adequate capacity to meet the health care needs of all Vermonters.”
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