Universal american healthcarePresentation 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
What is Medicaid? 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 COBRA Consolidated Omnibus Reconciliation Act of 1985 Passed by President Reagan Mandated an insurance program for people who left their jobs / laid-off SCHIP 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 coverage.
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.
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>.