UNIVERSAL HEALTH CARE

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UNIVERSAL HEALTH CARE

• The ins and outs of emerging health care plans.

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What is Universal Health Care?
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Universal Health Care

• Health care coverage extended to all citizens and
  sometimes permanent residents
• Vary in structure and funding
• Typically government regulation is involved

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Universal Health Care

• Typically health care cost funded via mandatory
  health insurance, taxation or a combination of
  both
• National Health Service in
• UK first Universal Health
• care system- 1948

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Universal Health Care

• Common concerns about Universal Health care
  systems
• - system funding/structure
• - government involvement
• - Does coverage mean access

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HEALTH CARE IN THE UNITED STATES TODAY
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Until 1940 90 paid for health care from their
own pockets.
Culture/Availability Uninsured
More Number Insured Less

• Prices stayed competitive.

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1943 - IRS ruled that health benefits paid by
employers were not taxable as income.
Furthermore, states granted tax exempt status to
private insurance companies.
Culture/Availability Uninsured
Business Provided Insurance
More Number Insured Less

• Tax breaks made it popular for businesses to
  insure their workers.

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1965 Medicare Medicaid Introduced
Uninsured
Medicaid
Medicare
Business Provided Insurance
More Number Insured Less
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Managed Health Care Cost Containment

• (HMOs, PPOs, POS Plans,PHOs)
• Health promotion is primary goal, but the
  majority of time is spent on diagnosis and
  treatment.

MCOs
Prospective Payment Systems

• providers receive payment on a per-case basis
  regardless of the cost to the provider.

• Tax Equity and Fiscal Responsibility Act.
  Medicare Payment based on DRGs. Incentives for
  cost effectiveness.

TEFRA

• initiatives introduced to protect consumers from
  under treatment.

Quality Management
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How Health Care Is Paid For
1960
2005
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How Much Does It All Cost
2,000,000,000,000.00
2005 National cost reaches two trillion dollars
1990's Cost reaches one trillion dollars
1,000,000,000,000.00
Cost
1965 Medicare Medicaid Introduced
1943 Tax breaks to insure workers
Year
http//www.ahrq.gov/news/press/pr2006/taxsubpr.htm
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How Much Does It All Cost Per Person?
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Who Is Not Insured?
SOURCE National Health Interview Survey, 2006
http//www.cdc.gov/Features/Uninsured/

• 29 of 1824 years were uninsured at a point in
  time (2005). More than twice as likely to be
  uninsured as those 4564 years of age.
• 8 of 10 uninsured are in working families.
• They cant afford insurance, but make too much to
  be eligible for Medicaid. cdc
• 19 of adults (18yrs) reported (2005) that they
  did not receive needed services because they
  could not afford them. cdc

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Health Care Safety Net

• Emergency Departments have to offer medical
  services regardless of a persons ability to pay.

• Must be screened stabilized.
• 1 of 3 patients served uninsured.
• 1 of 4 uninsured patients lt 18 yrs.
• Billions of dollars uncompensated to hospitals
  physicians each year.
• 6.1 billion in 1983
• 40.7 billion in 2004
• (ACEP survey 3/03)

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• Positives
• Amazing technology knowledge
• Nothing beats it if you have good insurance.
• Sophisticated imaging equipment is more available
  in the
• United States, compared with almost all other
  countries.
• The United States spends more
• on health per capita than any other country.
• In 2004, life expectancy at birth for the total
  population
• reached a record high of 77.8 years,
• up from 75.4 years in 1990cdc

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• Negatives
• Not available to everyone.
• Not enough Health Promotion,
• which could lower costs in the long run.
• Costs still rising due to
• Inflation
• New Technologies drugs
• Aging Population
• Increased demand for health care services
• Healthypeople.gov

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Universal Health Care The Pros and Cons

• The American Dream Being able to provide for
  your family

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Whats Wrong With This Picture?

• Health care costs continually rising
• The number of uninsured Americans rising along
  with it.
• More than 45 million lack health insurance
• Not just low-income Americans, the middle class
  suffering due to employers who are unable to
  provide health insurance benefits.

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The Insured

• Having to pay more for health insurance
• In a 2005 study, 7 out of 10 people who filed for
  bankruptcy because of a medical issue were
  insured.
• Being inadequately insured contributes to
  anxiety, familial stress, depression, and fear.

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How Could We Make It Work?

• Eliminating wasteful inefficiencies
• Duplicate paper work, claim approval, insurance
  submission, etc.
• A universal healthcare plan would allow for one
  centralized system, saving billions every year in
  banking and postal.
• Developing a centralized national database,
  instead of separate record-keeping systems at
  every doctors office.
• Diagnoses and treatment would be easier
• Save time and money

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What Else would Change?

• Medical professionals would have less reasons to
  worry about insurance procedures or malpractice
  liability, focusing more on simply helping
  patients!
• People avoid doctor visits for minor problems,
  but Free medical services
• Encourage patients to seek preventative care
• Catch diseases earlier on
• Treatment less costly

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Cons of Universal healthcare

• Government run healthcare really good?
• Not really free- Taxes
• Private practices have motivation
• Decreased patient flexibility (elective
  surgeries)
• Since its free patients will bother doctors for
  everything thats wrong

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Universal Health care doesnt allow for
Flexibility

• Reduced doctor flexibility
• Healthy people have to pay for the sick
• Insurance companies and private practice jobs
  will be lost

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Financial Dilemma

• Loss of private practices and possible reduction
  in pay
• Increase Malpractice lawsuits for the Government
• Hard to fix government programs

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Who is planning on voting in the presidential
election?
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Who feels informed enough to vote in the next
presidential election?
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What will the future hold in health care?

• Democrat
• Hillary Clinton
• Barack Obama
• Republican
• John McCain

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Hillary Clinton

• American Health Choice Plan
• If youre happy with your current coverage
• You can keep it
• if you do not have health insurance or wish to
  change
• choose from the same quality private health care
  options that members of congress enjoy
• choose a quality public plan similar to Medicare

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Who is required to have coverage?

• Require all Americans have health insurance
• Families would receive tax credits to help pay
  for coverage
• The tax credit would be designed to limit the
  premiums to a percentage of a familys income
• Federal subsidies would be provided for those who
  are not able to afford insurance

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How will insurance work through employers?

• Large businesses would be expected to provide or
  help pay for their employees' insurance.
• Her plan would not require small businesses to
  take part, but will offer tax credits to
  encourage them to do so.

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What happens to the insurance companies?

• This package/plan would require insurers to
  provide coverage for anyone who applies for it.
• Bar insurance companies from charging people with
  greater health care costs more for their premiums

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How will it be paid for?

• To help pay for the plan, Clinton would also
  eliminate the Bush tax cuts for those making over
  250,000 and limit the amount employers can
  exclude from taxes for health care benefits paid
  for those making over 250,000.

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Barack Obama

• Barack Obamas plan for a healthy America
• A nation health insurance program for individual
  who do not have employer-provided health care and
  who do not qualify for other existing federal
  programs.

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Who is required to have coverage?

• Required coverage for all children
• Encouraged coverage for all
• Children under 25 years of age will have the
  opportunity to be covered under their parents
  plans.

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What are my choices?

• It will allow individuals to choose between the
  new public insurance program from among private
  insurance plans that meet certain coverage
  standards

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Employers

• requires employers who do not provide health
  coverage for employees to play into the national
  insurance program

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How will it be paid for?

• eliminating bush tax cuts for those earning over
  250,000

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John McCain

• opposes federally mandated universal coverage

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What will be encouraged?

• Increase awareness and promote the use of
  existing childrens health insurance programs
  while expanding community health centers

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What will be supported?

• Health care tax dividends for low-income
  Americans
• Medical malpractice reform
• Improving electronic record keeping
• Expanding health savings accounts
• Encouraging small businesses to band together to
  negotiate lower rates with health care providers

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Nurses and Universal Health Care What Does it
Mean for Us?
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Nurses and Universal Health Care What Does it
Mean for Us?

• Millions of Americans across the nation are
  talking about the potential effects of universal
  health care and nurses are no exception.
• Only time will tell, but most Nursing
  Associations are supporting health care reform
  that benefits everyone.

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Nurses and Universal Health Care What Does it
Mean for Us?

• The nursing profession will undergo many positive
  changes with the implementation of a universal
  health care system, such as increase in quality
  of care, emergency department reform and an
  increase in nursing job satisfaction.

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Nurses and Universal Health Care What Does it
Mean for Us?

• Currently, insurance companies are gaining more
  control over patient care than practitioners
  leading to decrease in the quality of patient
  care.
• Following the nursing process is greatly affected
  by the complexities of the private healthcare
  system and by those who are uninsured.

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Nurses and Universal Health Care What Does it
Mean for Us?

• Increase in quality of patient care
• A health care system that benefits everyone will
  help to take the fear out of planning and
  implementing.
• Nurses can put patients back to the center of
  care rather than insurance companies and the
  bottom line being the first interest.

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Nurses and Universal Health Care What Does it
Mean for Us?

• Many of the inefficiencies seen in the ER are due
  to the regulations and requirements of the
  patients insurance.
• Most uninsured patients are financially unable to
  obtain preventative care or see a primary care
  physician. Instead, these patients turn to
  emergency departments for care.

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Nurses and Universal Health Care What Does it
Mean for Us?

• Much needed Emergency Department reform
• Nurses that are trained for trauma and
  emergencies can use their abilities on the lives
  that depend on them.
• Providing a means for everyone to seek out
  primary care will greatly impact the current
  state of our emergency departments.

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Nurses and Universal Health Care What Does it
Mean for Us?

• Increase in nursing job satisfaction
• A universal plan would alleviate the need for
  older nurses to continue working solely for the
  purpose of retaining their health insurance.
• A reform of our current health care has the
  potential to point us in the direction of
  improving our current hospital conditions. Money
  currently spent on overpriced health care could
  be redirected to improve facilities and work
  environment.

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Survey Says

• Survey is out of 20 people between ages 18-21
• Do you know what universal healthcare is?
• Yes 50 No 50
• Do you know what the upcoming candidates
  positions on Universal Healthcare?
• Yes 20 No 80
• Given that you pay 1/3 of your paycheck to taxes
  already would you be willing to pay additional
  1/3 so that everyone could have HealthCare (2/3
  total of paycheck)?
• Yes 20 No 80
• Would you be willing to wait (possibly years) on
  an elective surgery (non emergency) so that
  everyone can have healthcare?
• Yes 45 No 55
• Would you pay more out of your paycheck so that
  no one would have to pay for doctor visits,
  medical prescriptions, or surgeries?
• Yes 55 No 45
• Would you visit the doctor or seek more medical
  attention if you did not have to pay for the
  visit?
• Yes 45 No50
• Do you think its a right or a privilege that all
  people should have healthcare?
• Right? 80 Privilege? 20

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A Different Approach

• Improving the current status without decreasing
  quality or health care.

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UNITED NATIONS IN 1948, PROCLAIMED THAT EVERYONE
HAS THE RIGHT TO A STANDARD OF LIVING ADEQUATE
FOR THE HEALTH AND WELL-BEING OF ONESELF AND
ONES FAMILY, INCLUDING FOOD, CLOTHING, HOUSING,
AND MEDICAL CARE.
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Moral Health Care with a Free Market

• Child health care should be covered by hospitals
  or private organizations that fund childhood care
  when the parents cant afford treatment (St.
  Judes)
• Free market with a combination of Health Savings
  Accounts (HSAs) and high-deductible, low-cost
  catastrophic insurance
• HASs will be provided by employees
• Maintain individuals rights
• Lower costs higher quality