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Universal american healthcare






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    Universal american healthcare Universal american healthcare Presentation Transcript

    • Universal American Healthcare
      A presentation by
      Gary Sheets
    • History of National Reform
    • What is Medicare?
      Federally administered, not a private organization
      For the aged; 65 years + or disabled persons
      Pays a substantial amount or the total for health services, depending on the service
      Everyone pays into this program in working years, it comes out of your paycheck like social security
    • Medicare Spending
    • What is Medicaid?
      Federally and state funded program
      Provides health insurance for the needy (low income and lacking resources)
      State administered program
      States set their own guidelines but must comply with the federal government to receive funding
    • COBRA and SCHIP
      Consolidated Omnibus Reconciliation Act of 1985
      Passed by President Reagan
      Mandated an insurance program for people who left their jobs / laid-off
      State Children’s Health Insurance Program
      U.S. Department of Heath and Human services provide matching funds to families with children
      Intended to cover families with children with modest incomes but too high for Medicaid
      Bush Jr. denied expanding coverage because it would be a step towards federalized healthcare
      Barack Obama passed the Children’s Health and Reauthorization Act of 2009 which extended coverage to 4 million children and pregnant women as well as legal immigrants without a wait period
    • Before Universal Healthcare
    • Universal Healthcare, from a French Perspective
      Universal Healthcare
    • 2010 Key Reforms
    • Extend Health Insurance
      The health-care legislation signed into law in March 2010 is estimated to result in 32 million additional citizens
      being insured by 2019,
      but would still leave
      an estimated 23
      million without
    • Address Insurance Company Abuse
      Since the 1970s health insurance had began to compete not on service and price but by becoming good risk differentiators seeking to insure only those with good or normal health profiles and excluding those considered to be or to become unhealthy resulting in less profit.
    • Make Health Insurance More Effective
      By forcing insurers to cover more of a person's health care costs by excluding lifetime and annual caps, cover first dollar costs for screenings and immunizations and preventing exclusions for necessary care.
    • Reduce the Deficit
      The reform legislation that passed was estimated by the Congressional Budget Office to reduce the deficit by $138 billion over 10 years
      In the second 10 years it would reduce the federal debt by 1.2 trillion dollars.
    • Eliminate Overpayment in Medicare Advantage
      Medicare Advantage plans are offered by private insurers and provide benefits coverage in Medicare Parts A and B. However, under a revised contract during the previous Bush presidency, Medicare was overpaying the private insurers. MedPAC estimated the overpayment as being approximately $12 billion a year. This meant that the average person in traditional Medicare was paying $90 a year as a subsidy to private insurers for which they received zero benefit and eliminating this overpayment would save $177 billion over ten years.
    • Legal Challenges
    • 2010 Patient Protection and Affordable Care Act details
    • Within one year of enactment (2010–2011)
      Insurance companies cannot drop people from coverage when they get sick.
      Young adult able to stay on their parents health plans until age 26 since many current plans drop coverage once turning 19.
      Un-insured adult with pre-existing conditions will be able to obtain health coverage
      Health insurers cannot deny group coverage to children under 19 due to a pre-existing condition
      Tax credit to small business to help provide coverage for workers
      10% tax on indoor tanning
    • Effective during 2011
      10% bonus payments to primary care physicians and general surgeons
      Medicare will cover the full cost of annual wellness visits and personalized prevention plan services for beneficiaries.
      Payments to insurers offering Medicare Advantage services are frozen at 2010 levels
      Employers are required to disclose the value of health benefits on employees' W-2 tax forms
      An annual fee is imposed on pharmaceutical companies according to market share
    • Effective as of 2012
      An incentive program is established in Medicare for acute care hospitals to improve quality outcomes.
      The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions
      Physician payment reforms are implemented in Medicare to enhance primary care services and encourage doctors to form "accountable care organizations" to improve quality and efficiency of care
    • In 2013
      A national pilot program is established for Medicare on payment bundling to encourage doctors, hospitals and other care providers to better coordinate patient care.
      The Federal Insurance Contributions Act tax (FICA) is raised to 2.35% from 1.45% for individuals earning more than $200,000 and married couples with incomes over $250,000. The tax is imposed on some investment income for that income group.
      A 2.9% excise tax is imposed on the sale of medical devices. Anything generally purchased at the retail level by the public is excluded from the tax.
    • Effective as of 2014
      State health insurance exchanges for small businesses and individuals open
      Individuals with income up to 133% of the federal poverty level qualify for Medicaid coverage
      Healthcare tax credits become available to help people with incomes up to 400 percent of poverty purchase coverage on the exchange
      Most people required to obtain health insurance coverage or pay a tax if they don't.
      Health plans no longer can exclude people from coverage due to pre-existing conditions.
      Employers with 50 or more workers who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30 employees aren't counted for the fine.
      Health insurance companies begin paying a fee based on their market share.
    • The Cost of Care
      The Cost of Universal healthcare would be 940 billion dollars over the next 10 years.
    • Healthcare and Immigrants
      Illegal immigrants will not be allowed to purchase healthcare in the exchange, even if they completely pay with their own money.
      The coverage for legal immigrants is up for debate in congress. It seems like Republicans favor a 5 year wait for coverage while Democrats want initial coverage like any other legal citizen.
    • Pro Choice or Pro Life?
      Individuals seeking an abortion would have to make two payments to receive an abortion.
      Private funds would have to be kept in a separate bank account from Federal or taxpayer funds.
      No healthcare plan would be required to offer abortion coverage; in the future states could pass legislation to deny abortion coverage as well.
      An exceptions was made for rape, incest,
      and/or the mother’s physical or mental
      Health by Democrats, allowing federal
      funds to be used.
    • Works Cited
      Gratzer, David. "Why Isn't Government Healthcare the Answer?." Free Market Cure (2002): n. pag. Web. 25 Oct 2010. <http://www.freemarketcure.com/whynotgovhc.php>.
      "Health Care Statistics." Health Care Problems. Web. 29 Sept. 2010. <http://www.healthcareproblems.org/health-care-statistics.htm>.
      Jackson, Jill, and John Nolen. "Health Care Reform Bill Summary: A Look At What's in the Bill - Political Hotsheet- CBS News." Breaking News Headlines: Business, Entertainment & World News - CBS News. 21 Mar. 2010. Web. 29 Sept.2010.<http://www.cbsnews.com/8301-503544_162-20000846- 503544.html>.
      Kavilanz, Parija. "Underinsured Americans: Cost To You." CNN Money (2009): n. pag. Web. 25 Oct 2010. <http://money.cnn.com/2009/03/05/news/economy/healthcare_underi nsured/>.
      "YouTube - France: 'Best' Health Care?" CBS News. CBS. YouTube - Broadcast Yourself. 26 Oct. 2008. Web. 29 Sept. 2010. <http://www.youtube.com/watch?v=uNR_6UuVl4s>.