1. IDIOT-PROOF US HEALTHCARE a.k.a. I-PUSH Plan Text and graphics by: Solveig Wilder, MSW Based on a class given in Spring 2006 at the CUNY Graduate Center for Worker Education by: Nick Unger – Health Advisor to TWU Local 100 and board member of Universal Healthcare Action Network (UHCAN) . Featuring Guest Speakers: Dianne Archer - Medicaid Rights Center Jeff Gold – Working Families Party of New York Mark Hannay – Director of Metro NY Health Care for All Martha Livingstone, Ph.D. – Health and Society Department at SUNY Old Westbury Len Rodberg, MD - Physicians for a National Health Program (PNHP) With information and data from: Richmond, Julius B., MD, and Fein, Rashi, MD (2005): The Health Care Mess – How We Got Into It and What It Will Take To Get Out . Cambridge, MA: Harvard University Press. Bodenheimer, Thomas S., and Grumbach, Kevin (2005): Understanding Health Policy – A Clinical Approach (4th Edition). New York: Lange Medical Books/McGraw-Hill.

9. EXPENDITURES ON HEALTHCARE IN THE US HAVE INCREASED DRAMATICALLY SINCE 1960

10. TOTAL HEALTH EXPENDITURES AS A PERCENT OF GROSS DOMESTIC PRODUCT ARE HIGHEST IN THE US

11. BUT HEALTH OUTCOME RANKINGS FOR THE US ARE AMONG THE WORST IN THE WORLD COUNTRY INFANT MORTALITY RANKING (2002) Sweden 2.8 2 Finland 3.0 4 Japan 3.0 4 Spain 3.4 6 Norway 3.5 7 Austria 4.1 8 France 4.1 8 Germany 4.3 11 Denmark 4.4 12 Switzerland 4.5 13 Italy 4.7 14 Belgium 4.9 16 Australia 5.0 17 Netherlands 5.0 17 Portugal 5.0 17 Ireland 5.1 20 Canada 5.4 23 Greece 5.9 25 New Zealand 6.2 26 United States 7.0 28 Hungary 7.2 29 Poland 7.5 30 COUNTRY LIFE EXPECTANCY-MEN RANKING (2001) LIFE EXPECTANCY FOR WOMEN RANKING (2001) Japan 78.1 2 84.9 1 Sweden 77.6 3 82.1 9 Switzerland 77.4 4 83.0 3 Canada 77.1 5 82.2 8 Australia 77.0 7 82.4 7 Italy 76.7 8 82.8 6 Norway 76.2 10 81.5 11 New Zealand 76.0 11 80.9 17 Netherlands 75.8 13 80.7 18 Spain 75.6 14 82.9 4 Austria 75.6 14 81.5 11 Germany 75.6 14 81.3 14 France 75.5 18 82.9 4 Greece 75.4 19 80.7 18 Belgium 74.9 21 81.1 15 Denmark 74.7 22 79.3 27 Ireland 74.7 22 79.7 26 Finland 74.6 25 81.5 11 United States 74.4 26 79.8 25 Portugal 73.5 27 80.3 21 Poland 70.2 32 78.3 32 Hungary 68.1 35 76.4 34

12. GREAT BRITAIN HAS UNIVERSAL HEALTHCARE AND MUCH BETTER RESULTS

13. UK NATIONAL HEALTH INSURANCE VS. US HEALTHCARE SYSTEM Tier 1 - Primary Care: Focus is on treating common health problems and implementing preventive measures throughout the UK. Everyone is assigned a General Practitioner (GP), who is responsible for developing treatment plans, providing treatment for common health problems, monitoring health, and making referrals for more serious health problems. Tier 2 - Secondary Care: Focus is on more serious ailments that affect approximately 10 to 50 percent of the population. Patients are assigned to a Specialist in things like surgery, neurology, OB/GYN, pediatrics, and psychiatry. Tier 3 - Tertiary Care: Focus is on the most serious ailments that affect approximately 10 percent of the population. Patients are assigned to a Sub-Specialist for things like heart disease and spinal injuries. Progressive Tax: 82% Employer-Employee Contributions: 13% User Charges: 4% FINANCING: SINGLE-PAYER (mostly Government Financing) DELIVERY: SOCIALIZED (mostly Government-Run Facilities) ACCESS: OPEN TO EVERYONE No distinction is made between the employed and unemployed, or s ocial insurance and public assistance. FINANCING: MULTI-PAYER Government (Regressive Tax) Private Insurers DELIVERY: MULTIPLE PROVIDERS ACCESS: OPEN TO SOME CITIZENS Employers Individuals For-Profit Agencies Hospitals Non-Profit Agencies Nursing Homes Mental Institutions Schools & Universities Research Programs Private Practice Those with MONEY Those with INSURANCE The DESERVING POOR

15. PRESIDENT GEORGE W. BUSH SUGGESTED MORE MODEST REFORMS IN HIS STATE OF THE UNION ADDRESS HEALTH CARE FINANCING WHO WILL PAY? Healthcare will pay for itself with money saved from “health savings accounts,” and by curtailing lawsuits, closing loopholes, privatizing healthcare, and increasing efficiency (i.e., reducing medical errors and increasing the use of electronic records). WHO WILL BENEFIT? American business, because it keeps them “competitive;” the elderly; and “the needy.” WHO WILL SACRIFICE? Virtually no one, because it “eliminates the need for sacrifice.” HEALTH CARE ACCESS HEALTHCARE AVAILABLE TO: “All Americans.” UNCLEAR how all Americans will access healthcare. UNCLEAR what the barriers to access will be. HEALTH CARE DELIVERY HEALTHCARE DELIVERED BY: more private agencies and fewer government agencies. UNCLEAR how healthcare will be organized. UNCLEAR what the quality of healthcare will be.

17. BUT I PREDICT AMERICANS ARE GOING TO LOVE IDIOT-PROOF US HEALTHCARE

18. IDIOT-PROOF US HEALTHCARE IS SO EASY TO UNDERSTAND HEALTH CARE FINANCING WHO WILL PAY? Federal/State governments with funds from a progressive tax (Single-Payer). WHO WILL BENEFIT? Virtually everyone. WHO WILL MAKE SACRIFICES? Rich people with VERY little time to spare. HEALTH CARE ACCESS HEALTHCARE AVAILABLE TO: Everyone in the US, including immigrants and tourists. BARRIERS TO ACCESS: All barriers related to financial circumstances, employment, geography, demographics, etc., will be eliminated – along with the paperwork! HEALTH CARE DELIVERY HEALTHCARE DELIVERED BY: Government-Run Agencies (Single-Provider). HEALTHCARE ORGANIZED: As simply and comprehensively as possible, with a heavy emphasis on general practitioners. QUALITY ASSURED BY: Top-notch computer tracking systems and quality assurance teams staffed with consumer advocates.