Health Care Reform
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Health Care Reform






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Health Care Reform Health Care Reform Presentation Transcript

  • Health Care Reform January 12, 2009
  • Medi NEGLECT
  • Health Insurance Coverage in the U.S. in 2006
    • Medicare is a social insurance program that provides health coverage to individuals, without regard to their income or health status
    • 16% are under 65 and permanently disabled
    What is Medicare?
    • Fee-for-service (FFS) or private health plans (HMOs, PPOs)
    • Advantage plans generally provide all benefits covered under traditional Medicare, but many plans offer additional benefits
    How are benefits provided?
  • Video
    • 10.1 million beneficiaries are now enrolled in a Medicare Advantage plan, up from 5.3 million in 2003
    • Government pays 113% more for beneficiaries enrolled in Medicare Advantage than for beneficiaries in traditional Medicare in 2008
    Quick Facts on Medicare
    • By 2019, there will be insufficient funds in the Medicare Part A (Hospital Insurance) Trust Fund to pay for benefits
    • Current benefit levels cannot be sustained without additional revenue
    Financing Care for Future Generations
  • Medicare Revenue and Spending
    • Medicare is 14% of the federal budget
    • From 2010 – 2030, the number of people on Medicare is projected to rise from 46 million to 78 million
    • Medicare covers less than half of beneficiaries’ total medical and long-term care expenses
    Quick Facts on Medicare
    • Medicare is listed as a “high-risk” government program
    • Fewer than 5% of Medicare claims are audited
    • Medicare fraud costs taxpayers over $60 billion a year
    Medicare Fraud
    • Medicaid is a joint program with costs shared by federal & state government
    • Largest children’s health program
    • Each state establishes its own standards for Medicaid eligibility, benefits package, & provider payment rates
    What is Medicaid?
    • Medicare is a federal program that covers 43 million senior citizens and retirees over 65
    • Medicaid is a program designed to provide health coverage for children
    • Medicaid and Medicare share other costs associated with “dual eligibles”- people who qualify for both programs
    Is Medicaid the same as Medicare?
    • 3 in every 10 American children are enrolled in Medicaid
    • Over ½ of Medicaid enrollees are children
    • Medicaid serves over 24 million
    • Each state establishes its own standards for Medicaid eligibility
    Quick Facts on Medicaid
    • So what do Medicare and Medicaid cost?
    • $320 billion
    Cost of Medicare and Medicaid Medicaid Medicare + $440 billion $760 billion
  • Video
    • 47 Million Americans
    • 1.3 million full-time workers lost coverage in 2006
    • 37.7 million workers uninsured in 2006 because their businesses did not provide quality coverage
    Who are the uninsured?
    • Uninsured are paying “up front”
    • 20% of uninsured say their usual source of care is the emergency room
    • Deaths among uninsured adults 25-64 is 18,000 a year
    How does being uninsured harm individuals and families?
    • US spends $100 billion per year to provide uninsured residents with health services
    • Hospitals provide $34 billion worth of uncompensated care a year
    • An additional $37 billion is paid by private and public payers for health services for the uninsured and $26 billion is paid out-of-pocket by those who lack coverage
    How it Affects You
    • The US has spent $656.1 billion on the war in Iraq to date
    • With the money spent on the Iraq war, the US could insure 193,370,980 people with health care for one year
    How it Affects You (con’t)
    • So how can we fix the Health Care Crisis?