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"Nearly 47 million Americans without health coverage: is incremental reform working?" 2007 ACCI Annual Conference Esther Peterson Consumer Policy Forum.

Esther Peterson once said:

"We have a tremendous responsibility to future generations to leave an accurate record of our history, one which lays bare not only the fact, but the process of change."

"AN ACCURATE RECORD OF OUR HISTORY" ... 2007

* 47 million Americans without any health coverage

* PRICE TAG: $65 and $130 billion annually (IOM)

* 18,000 people die/year in the US (preventable deaths) (IOM)

-- MD

"AN ACCURATE RECORD OF OUR HISTORY".... 47 million people The Uninsured

* 80% in a family with at least 1 worker

* 2/3 are below 200% FPL

* 1 in 5 uninsured are kids

* 16+% of our population is uninsured (under age 65)

* In some states--TX: 1 in 4 people are without health insurance coverage (25% of the population)

"AN ACCURATE RECORD OF OUR HISTORY" ... uninsured and underinsured

* Medical problems/illness--leading cause of personal bankruptcy (majority had health insurance) (Warren 2006)

* $45 BILLION/year cost shifting to privately insured people--$1000/family in additional premium/year (Thorpe 2006)

"AN ACCURATE RECORD OF OUR HISTORY" .... the cost of health coverage (problems broader than the uninsured)

* GM--$1500/car

* Big 3 automakers spend more on health coverage than on steel

[GRAPHIC OMITTED]

* Double-digit annual premium increases

* Cost-shifting (cuts in benefits, higher cost-sharing like deductibles, copay's etc.)

* Increases in the cost of health insurance outpaces inflation

"AN ACCURATE RECORD OF OUR HISTORY"

* Over 120 million people with chronic conditions

* Aging population

* Public insurance--financial pressures on programs (Medicare, and MEDICAID and SCHIP--state shortfalls--no $$)

* Industry: United CEO $1BILLION bonus

[GRAPHIC OMITTED]

Process for change: Incremental Reform and Financing Medical Care

* Economic impact

* Impact on our communities

* Impact on our friends and neighbors

* American values

POLITICAL REALITY NEXT STEPS

"Process of change" ... political reality

LOBBYING $$ 2006:

* Pharmaceuticals/Health Products: nearly $167 million

* Insurance: $129 million

POLITICAL CONTRIBUTIONS:

* Insurance: nearly $31million

* Health: $98.6 million

Other considerations:

Public demand:

* Health #1/top issue or concern (public opinion)

* Lessons from history

* Cultural issues: "government"

* Cost-benefit to individuals: Will I be better off?

What will I have to give up? What will I get? Federalism: state v. federal Ideology

"You may have to fight a battle more than once to win it."

Margaret Thatcher

"We didn't intend to rock the boat ... We intended to sink the sucker."

Author Unknown

Mila Kofman, J.D.,

Associate Research Professor

Health Policy Institute

Georgetown University
"AN ACCURATE RECORD OF OUR
HISTORY".... spending on health care ($)

2004: $1.878 Trillion (16% of GDP)
2000: $1.359 Trillion (13.8%)
1990: $717 Billion (12.4%)
1980: $255 Billion (9.1%)
1970: $75 Billion (7.2%)
1960: $28 Billion (5.2%)

Access Problems Because of Costs in Five Countries, 2004

% of adults who had any of three access
problems * in past year because of costs:

* Did not get medical care because of cost of
doctor's visit

* Skipped medical test, treatment or follow-up
because of cost

* Did not fill Rx or skipped doses because
of cost.

UK 9
CAN 17
AUS 29
NZ 34
US 40

Note: Table made from bar graph.

Life Expectancy at Birth in 2003
(source: Commonwealth Fund)

 Female Male

Japan 85.3 78.4
France 82.9 75.8
Australia 82.8 77.8
Canada (a) 82.1 77.2
Germany 81.3 75.5
New Zealand (a) 81.1 76.3
OECD Median 81.1 75.5
Netherlands 80.9 76.2
United Kingdom 80.7 76.2
United States (a) 79.9 74.5

(a) 2002

Source: OECD Health Data 2005.

Note: Table made from bar graph.

"the process of change".... incremental

1965: MEDICARE AND MEDICAID
1974: ERISA
1985: COBRA
1996: HIPAA
1998: SCHIP
1996-8: MHPA, NMHPA, WHCRA
2003: MEDICARE PART D
2003: HSAs

"AN ACCURATE RECORD OF OUR
HISTORY" ... uninsured and counting

1990: 34.7 million people
2000: 39.8 million people
2005: 46.6 million people
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Author:Koftman, Mila
Publication:Consumer Interests Annual
Geographic Code:1USA
Date:Jan 1, 2007
Words:632
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