Health Care Reform


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  • Health Care Reform

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