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1. The Ohio Health Care Security
Act
Donald L. Rucknagel, M.D.
Richard Bozian, M.D.
Michael Shryock, Modertor
SPAN Ohio
2. Patient Protection and
Affordable Care Act Good News
• 32 million more insured by 2019
• Subsidies for lower Income people
• Children allowed on parents’ plans till age 26
• 16 million more on Medicaid
• $11 Billion more for community health centers
• Personalized preventive health services
• Phase out “donut hole” for Rxs by 2020
• 10% bonus for primary care physicians
3. Patient Protection and
Affordable Care Act Bad News
• Surging costs not contained
• Falls short of universal coverage
• Quality of care unlikely to improve
• Reforms incomplete and ineffective
• New layers of waste and bureaucracy
• Lack of price controls
• Perverse incentives retained
• “Reform” not sustainable
4. U.S. Health Reform, Briefly
• 1912: Teddy Roosevelt.
• 1927: Dr. Siegrist and committee on costs of
medical care.
• 1937: Wagner Health Act.
• 1940s: WWII – wage and price controls make
health insurance a workplace benefit.
• 1949: Truman – national health care plan.
5. U.S. Health Reform (cont.)
• 1960: Nixon and Kennedy debate national health
insurance.
• 1965: Johnson, Medicare and Medicaid.
• 1974: Nixon and the HMO act.
• 1990-94: Wofford and the Clinton fiasco.
• 1996: Presidential health care debate.
• 2000: Bradley v. Gore.
7. Who Are The Uninsured?
Source: Himmelstein & Woolhandler - Tabulation from 1999 CPS
*Students>18, Homemakers,
Disabled, Early retirees
»Employed
»50%
»Children
»25%
»Unemployed
»5%
»*Out of labor
»force
»20%
8. The Problems
• 18,000 Americans died last year because they
couldn’t afford health care.
• 46 percent of personal bankruptcies are related
to medical expenses.
• The World Health Organization ranks the U.S.
health care system 37th in quality.
• The insurance industry provides coverage but
denies care
• Lack of empathy whereby we help one another
9.
10. Comparative Costs of Health Care
$0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000
Japan
U.K.
Italy
Sweden
France
Germany
Canada
U.S.
Total Spending U.S. Public U.S. Private
11. The Problems (cont.)
• Drug spending has increased five-fold since 1990.
• $11.6 billion of the $70 billion cost in Ohio is
wasted annually by a complex and inefficient
private health insurance system that wastes 20%-
30% of the health care dollar.
• Health care costs are a drag on the economy
12. Consequences of the Uninsured
• Emergency rooms are clogged with persons with minor
illnesses, or persons with far-advanced problems, both of
which are expensive.
• The costs are transferred to third-party payers.
• Rising premiums cause companies to cancel insurance or
pass along costs in form of unaffordable co-pays or
deductions, all of which create more uninsured, causing
more people to go to emergency rooms.
• The system is imploding.
• Empathy deficiency.
13. The Solution to the Health Care Mess
• An Institute of Medicine report 6 years ago said
that the present system of medical care is
unsustainable in the 21st
century.
• The report laid out the characteristics of a
sustainable system.
• The report advocated a national health plan.
14. The Situation in Ohio
• 1.6 million people lack health insurance and another
1 million are under-insured.
• Two people die each day because they lack health
insurance
• We now have a plan called The Ohio Health
Security Act-S.B. 112 and H.B. 287
15. Ohio Health Care Plan
• In- and out-patient care.
• Emergency services.
• Vision, hearing, dental.
• Prescription drugs.
• Mental Health.
• Rehabilitation.
• Preventative care.
• Home nursing.
• Hospice care.
• Other needed services
services.
16. Administered by
Ohio Health Care Agency
under Direction of Ohio Health Care Board
• Negotiate or set prices.
• Pay for services.
• Establish standards for proof of residency.
• Provide each participating individual with
identification that will be used to establish
eligibility for services.
17. The Ohio Health Care Board
• One member selected from the largest
county of each of Ohio’s seven health care
regions
• Another selected from another county in
the region
• Chaired by the Director of the Ohio
Department of Health
• Administratively efficient
18. In addition to administrative cost savings,
OHIO HEALTH CARE PLAN
will be financed by the following:
• [Up to] 3.85% payroll tax paid by employers.
• [Up to] 3.00% gross receipts taxes paid by businesses.
• 6.20% tax on wages and salaries above $106,800.
• 5.00% tax on incomes above $200,000.
• Funds from current government sources such as Medicare
and Medicaid.
• It is the Legislature’s prerogative to change or adjust the tax
plan, however.
Administered by the State of Ohio
19. How the
Ohio Health Security Act
Will Work for You
• Freedom from bankruptcy due to lack of health insurance
• Freedom to chose your own health care providers
• Freedom from co-pays and deductibles
• Freedom to work in a job you love rather than on the basis of
insurance coverage
• Freedom from need for Medicare supplemental insurance
20. How the
Ohio Health Security Act
Will Work for You (cont.)
• Your care is better. You choose your own
doctor who practices evidence-based
medicine
• You sleep better. Your employer no longer
has to worry about the ever-increasing
costs of health care, and you, in turn, no
longer have to worry about increasingly
unaffordable deductibles and co-pays. In
addition, you and your family are covered
when traveling out of state.
21. Ripple Effects
• Employers will pay less in taxes than in insurance
premiums.
• All businesses will help pay.
• Ohio Health Care Plan will supplement Workers’
Comp.
• It may decrease the number of claims
• Auto insurance premiums will decrease.
• Ohio businesses will become more competitive.
• Drag on economic growth will be reduced.
• Nursing home care will be less expensive.
22. Ripple Effects (cont.)
• Medicaid/Medicare fraud will be detected easier.
• Drug idiosyncracies and toxicity will be detected
sooner.
• Physicians will want to practice in Ohio.
• Nurses will want to move here, too.
• Physicians will practice less defensive medicine.
• Individuals’ increased taxes will be offset by saved
health insurance premiums.
• Hospitals will render less charity care.
23. Ripple Effects (cont.)
• Welfare rolls will decline.
• Increased reproductive services will result in
fewer unplanned pregnancies and abortions
among poor women.
• Veterans whose illness is not related to their
military service will leave the Veterans’ Hospital
system.
• Pharmaceuticals will be less expensive.
• Employment options will increase.
• Resources will be available to combat obesity.
• Greater transparency will allow quality of care to
be monitored more effectively.
24. Ripple Effects for Physicians
• Physicians will be sued less often
• Physicians will no longer struggle to pay clerical
staff.
• Insurance companies will no longer dictate how
physicians practice medicine.
• Quality of medical care will improve, in part
because everyone will be covered.
• More and more medical care will be evidence-
based, therefore, better.
• Your payment will be guaranteed.
25. Ripple Effects for Physicians (cont)
• Medicaid payments will be supplemented by Ohio Health
Care Plan
26. Ripple Effects for Small Businesses
• Employers will pay less in taxes than in insurance
premiums.
• All businesses will help pay.
• Ohio Health Care Plan will supplement Workers’ Comp.
• It may decrease the number of claims
• Auto insurance premiums will decrease.
• Ohio businesses will become more competitive.
• The work force will stablize
27. Ripple Effects for Small Businesses
• Individuals’ increased taxes will be offset by
saved health insurance premiums.
• Your work force will be more stable.
28. Funding the Ohio Health Care Plan
• Issued by Single-Payer Action Network Ohio (SPAN
Ohio)
• Visit our web site at www.spanohio.org or call 216-736-
4766 or email SPANHealthCare@aol.com
• Contributions appreciated. Please send checks made
payable to:
• SPAN Ohio 3227 W.25 St.— Cleveland, OH 44109
29. PHYSICIANS FOR A NATIONAL HEALTH PROGRAM
29 EAST MADISON
SUITE 602
CHICAGO, IL 60602
TEL: (312) 782-6006
WWW.PNHP.ORG
Editor's Notes
So what are the barriers? There are about 47 million uninsured Americans despite spending $2.2 trillion annually. This is about 1/6 of the entire country uninsured and 16 % of our GDP. The number of uninsured has grown by about a million each year for the past 10 years.
Contrary to popular thinking, the uninsured are not the chronically unemployed or illegal immigrants. Almost 80% of the uninsured are working people and their kids.
It is easy to see from the following graph that our health care system has become a jobs program for paper pushers and bureaucrats disguised as a health care system. Over the past 30 years the number of doctors and nurses has grown between 200 and 300%. The number of non-clinical health care personnel has grown over 2500%. Most of these people are chasing the money. We now spend over 30% of the health care dollar on administration rather than care. No other country comes even close. Most average well less than half that amount. Here lies the money needed to cover the uninsured. If we spent the same amount as Medicare on insurance administration, we would have enough money to cover all the uninsured and improve coverage for the rest of us. Multiple studies at the national and state level confirm this amazing finding. We are paying for a national health insurance system. We are just not getting it. We are wasting the needed money on administration and profits that are directly related to our complex system of private insurance. We should not subject ourselves to the rationing of care by HMO’s before we ration this outrageous and wasteful bureaucracy that provides no care and no relief of suffering.
Physicians for a National Health Program represents over 15,000 caring professionals who believe that America needs a national health insurance program. This slide show is the result of their work and advocacy across the country for almost 20 years. It makes the case that the best alternative to our ongoing health care crisis is to develop a national health insurance program based on an improved and expanded Medicare for all. That program is embodied in HR 676, the United States National Health Insurance Act, sponsored by 93 members of 110th Congress.
