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Getting real about single payer
- 1. Getting Real About Single Payer: The Economic Argument for the Long Term Walter Tsou, MD, MPH Health Care for All Pennsylvania February 7, 2015
- 2. Pennsylvania in a Pickle • $2+ billion dollar deficit • Revenue from shale gas much less than predicted • Huge pension obligation • Restore $1 billion of public education funding? • Republican legislature tax adverse • Cut spending? But where?
- 3. What would you cut to get $3 billion? Zogby, 2014-15 Mid Year Budget Briefing, Dec. 3, 2014
- 4. What is the biggest ignored waste of taxpayer funds?
- 5. US spends more per capita OECD Health Data, Kaiser Family Foundation
- 6. $750 Billion on Unnecessary Care?
- 7. The Cost of Unnecessary Care? Institute of Medicine, “Best Care at Lower Cost, Sept 2012
- 8. Billing and Insurance Costs 18% of US Health Care Costs Jiwani et al. BMC Health Services Research (2014)14:556
- 9. Single Payer savings $375 BILLION in US Jiwani et al. BMC Health Services Research (2014)14:556
- 10. Why single payer saves money? • Competitive purchasing of services (free market) • Negotiated fee schedules and prices • Reduced administrative costs • Robust information management system
- 11. Affordable Care Act vs. Single Payer
- 12. State single payer bill • The Family and Business Health Security Act would cost 10% of payroll and 3% personal income tax for individuals • Comprehensive coverage for all medical, vision, dental, mental health and long term care services • Coverage for life (eliminates need for retiree health costs for those who stay in Penna)
- 13. Outside Economic Analysis • Dr. Gerald Friedman, Professor of Economics, Univ. of Massachusetts studied the plan • $17 billion annual savings
- 14. Education funding • Restore $1 billion in cuts • 10% payroll vs. 2009 school district health spending (19.4%)? • Savings for school districts? $1.15 billion
- 15. Pension funding, 2 parts • Pensions – wages post retirement –somewhat funded • Other Post Employment Benefits – pay as you go – Health care premiums – Life insurance premiums – Deferred compensation
- 16. Retiree Health Care The hidden costs Zogby, 2014-15 Mid Year Budget Briefing, Dec. 3, 2014
- 17. Accrued Retiree Health Unfunded Liability is over $16 BILLION! Hay Group, August 21, 2013, “Actuarial Valuation of the Post Retirement Medical Plan”
- 18. Bottom Line, $2.5 Billion annually for Retiree Health Costs just in PA Hay Group, August 21, 2013, “Actuarial Valuation of the Post Retirement Medical Plan”
- 19. Retiree Health Care Costs • Only a single payer plan can you guarantee coverage of future health care costs • Converts an accrual $16 billion liability to a pay as you go liability – much more affordable
- 20. Expand Medicaid • While we support, it maintains the enormous administrative waste • No cost containment features
- 21. Summary • Single payer is the only solution that can generate billions in state savings • Able to save in education, pensions, and Medicaid • The alternative budget are unconscionable cuts