Some Choices Don’t Really Matter!

Public Support – Single Payer

Polls from 20091 April, Kaiser Family Foundation2 January, Grove Insight Opinion Research3January, New York Times/CBS News

☤ 49% favor coverage from a single govt. plan1

☤ 59% prefer a system like Medicare for all2

☤ 59% say government should provide national health

insurance3

Obama on Single Payer

“A single payer plan is what I would like to see.” - addressing an AFL-CIO group in Chicago, 2003

“If I were starting from scratch, if we didn't have a system in which employers had typically provided health care, I would go with a single payer system.” - January 22, 2008, and many times after that

Kidney Transplants

OECD, 2004 (2002 Data, Canada and Sweden are 2001)

Rampel, US Health Spending Breaks From the Pack, NYT 7/8/09

National Health Spending % GDP

WORLD’S TOP 10 DRUG COMPANIES AND PRESCRIPTION DRUG SALES

2008

Total: 5 American, 5 European, $310 billion

Source: IMS Health “Top 15 Global Corporations” www.IMSHealth.com, accessed 8/27/09

Copyright ©2004 by Project HOPE, all rights reserved.

Uwe E. Reinhardt, Peter S. Hussey, and Gerard F. Anderson, U.S. Health Care Spending In An International Context, Health Affairs, Vol 23, Issue 3, 10-25

Nancy Swigonski, MD, MPH

Unnecessary Procedures

Nancy Swigonski, MD, MPHTrouble Getting Needed Care

Source: Commonwealth Fund Survey, 1998

Nancy Swigonski, MD, MPH

P

Indiana

Source: Centers for Medicare and Medicaid Services Health Expenditure Data, Health Expenditures by State, 2007

• Expenditures– In 2004, $33 billion on health care– 14.4% gross state product– $5,295 for every man, woman and

child• Outcomes– Age-adjusted mortality rate 6.2%

higher than national average– Excess mortality in diabetes and

cancer

Nancy Swigonski, MD, MPH

P

Indiana

Source: Centers for Medicare and Medicaid Services Health Expenditure Data, Health Expenditures by State, 2007

Hospital

Nursing

HomeDrugs Physici

anOther

Indiana $2,051 $461 $796 $1,264 $723

US $1,931 $392 $757 $1,341 $861

Per Capita Health Expenditure, by Type, Indiana and US, 2004

Nancy Swigonski, MD, MPH

• 1/2 U.S. deaths occur as a result of preventable causes

• Yet > 95% of our health-care spending is committed to diagnosis and treatment as opposed to prevention

Nancy Swigonski, MD, MPH

More “Productive” Physicians Provide Poorer Care

Source: Arch Int Med 1999; 159:294 Fast physicians = those seeing more pts./hour than averageSlow Physicians = those seeing fewer pts./hour than average

Taming the Deficit, Rosnick and Baker, CEPR Dec ‘09

“Kids, your mother and I have spent so much money on health insurance this year that instead of vacation, we’re all going in for elective surgery.”

Milton Friedman “Few trends could so

thoroughly undermine the very foundations of our free society as the acceptance by corporate officials of a social responsibility other than to make as much money for their shareholders as possible.”

Capitalism and Freedom, 1962