Quality, Affordable Health Care for All

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Quality, Affordable Health Care for All How do
we get there? Richard Kirsch Citizen Action
of New York December 2007
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Goal A solution to the problem that the public
will support.
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The problem is that health care costs too much.
Its bankrupting families, business and
government.
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Health care is the top domestic issue for voters.

• Which of the following issues do you think the
  President and Congress should be paying the most
  attention to? (Pick 2)
• The war in Iraq (40)
• Health care (29)
• The economy and jobs (24)
• NPR Poll October 2007

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• 94 of voters in November 2006 were insured.

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Distribution of Health Insurance Coverage, New
York City, Rest of State, and New York State,
20042005
Rest of State
New York State
3.4 6.5 9.8
0.3 0.4 0.7
2.2 1.6 3.8
1.2 1.0 2.2
N (in millions)
Note Data include all persons below age 65.
Urban Institute and United Hospital Fund, Health
Insurance Coverage in New York, 2004-05.
September 2007.
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Quality affordable health care for all.

• Across the board, voters agree with the central
  principle that every American should have access
  to quality affordable health care. That unites
  the insured, uninsured, and underinsured.

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In principle, over two thirds of all voters favor
health care access for all Americans, a majority
strongly, even if it means higher taxes or a
major government role.
72
70
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Do you favor or oppose providing access to
affordable, quality health care for all Americans
even if it means raising your taxes?
Do you favor or oppose providing access to
affordable, quality health care for all Americans
even if it means a major role for the federal
government?
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So why no change?The solution is the problem!

• The health care debate changes fundamentally when
  it moves from problem to solution.

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What do people say they want in health care
reform?

• Peace of mind be able to keep what they have if
  they like it, or have a choice
• Personal responsibility
• Prevention
• Everyone contributes even a little
• Government as a watchdog
• Not government providing health care
• An American Solution

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Quality Affordable Health Care for All

• Guarantee that everyone in America is covered
• Benefits that meet our needs
• Preventive care to serious, chronic illness
• Affordable on a sliding scale
• Premiums and out of pocket costs
• Government as a watchdog
• No pre-existing condition exclusions or other
  rules that deny needed care
• Choice of a public or private plan
• Choice of doctor and provider
• Guaranteed Affordable Choice

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Guaranteed Affordable Choice

• Preferred 3 to 1 to consumer driven health care
• GAC gets 67 vs. HSAs 20
• GAC gets 65 vs. Tax Credits 20
• Preferred 3 to 1 against just public insurance
• GAC gets 64 vs. Single Payer 22
• A single government-financed health insurance
  plan for all Americans financed by tax dollars
  that would pay private health insurance providers
  fro a comprehensive set of medical services.
• Source Herndon Alliance poll by Lake Research
  Partners, September 2007

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Standards for Quality Affordable Health Care for
All

• Guaranteed coverage
• Benefits that meet peoples needs
• Affordable to individuals
• Affordable to employers
• Strong regulation of private insurance
• Choice of a public plan
• Equity for communities of color, people with
  chronic illness and disabilities

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Governor Spitzers Approach

• Spitzers Partnership for Coverage
• Universal coverage based on building blocks
• Predicated on controlling costs
• Proposal Expected in the spring

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Other New York Proposals

• Single-Payer
• All publicly funded. Coverage through public
  insurance.
• Assemblyman Gottfrieds New York Health Plus
• Publicly funded. Coverage through Family Health
  Plus, public insurance or private
• Expansion of subsidized coverage
• Expansion or universal
• United Hospital Fund / Community Services Society
• Insurance company proposals
• Fewer benefits higher out of pocket costs
  dilute community rating state reinsurance
  following Healthy NY

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New York Modeling Plans

• RFP awarded to model plans by early spring
• Single payer will be modeled
• Others to be determined

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Federal Action?

• Only if a Democrat wins
• What will it mean for state reforms
• In the short term?
• In the long term?

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New York as a Leader

• Workers compensation
• EPIC
• State Child Health Insurance
• Will we lead on
• Quality Affordable Health Care for All?