Fact Sheet on Single-Payer Health Care for California: SB 810
The California Universal Healthcare Act -- SB 810 is . . .
- The gold-standard system: Full-choice, private delivery of care; public funding and stewardship.
- Lifelong, comprehensive benefits that are predictably affordable for ALL Californians.
- Fiscally sound financing that controls increases in healthcare costs.
- Reinforces the patient – provider relationship.
UNIVERSAL: Based on residency in California; i.e.,
physical address. “Presumption of eligibility.”
CONTINUOUS: Lifelong, irrespective of health or employment status,
income level or age.
- “Womb-to-Tomb” – Never again worry about healthcare coverage for you or your family.
PREDICTABLY AFFORDABLE: 95% of Californians will have net total health care cost savings.
- Health premium based on income (Lewin Report: People with income < ~$150k will pay the same or less than currently .) 1
- Via automatic payroll deduction (as in MediCare)
- Strict limits on deductibles and out-of-pocket payments (minimizes unexpected costs)
- Actual contribution % determined by Premium Commission, upon passage and enactment of Bill
SUSTAINABLE: Funds go to clinical care, not paperwork and profit
- ONE publicly-accountable Healthcare Fund (HF) which pays all providers and services
- Maximum 5% administrative overhead
- Permits “wrap-around” coverage (for benefits not provided) by private, for-profit insurance industry
PROMOTES HEALTH – comprehensive and integrated benefits – medical, dental, mental health, vision all in one
- Creates a proactive healthcare system based on prevention of illness and public health initiatives
- Establishes electronic records/payment infrastructure; reduces medical errors, saves lives and creates jobs!
GOOD FOR PROVIDERS – Requires “actuarially sound” payments and “adequacy of network” standards
- Retains private delivery system: Providers “opt-in” or out (95% provider participation)
- Patients have full choice of provider (doctor and hospital).
- Eliminates uncompensated care: Providers receive payment for all covered services.
- Guaranteed, electronic payment within 30 days.
- Bargaining power: Providers negotiate with Payments Board to set payment schedule
GOOD FOR BUSINESS – A true “stimulus” package, would save CA more $$ than our current deficit!
- Grows economy – creates jobs; increases business revenue; provides tax base (national model) 2
- Eliminates “job lock” -- decreases American productivity and international competitiveness.
- Regains lost potential productivity ($65-$130B, nationally) due to poorer health of uninsured 3
- Severs the employer obligation and hassle to purchase and providehealth “benefits”
California can no longer afford NOT to adopt the CA Universal Healthcare Act!
Framing True Universal Healthcare Reform
- CARE, not Coverage: “A card in your wallet that gets you the CARE you
need!”
Focus of healthcare reform must address access to CARE, using IOM criteria - Align Incentives towards health
Per the World Health Organization, healthcare systems must be publicly financed - We’re in this together: Segregation based on “healthy vs. sick” has
led to uncontrolled inflation of healthcare costs.
Fixed costs: 70% of healthcare spending funds infrastructure because we want it there when we need it!
The unique economic model of healthcare has been costly, uneven and unpredictable.
Funding occurs via social insurance: The healthy support the sick; likewise, the wealthy support the “poor”
SB 810 is consistent with the US Institute of Medicine (IOM)'s
Guiding Principles for Health Insurance Reform
- Universal: Everyone included
- Continuous: Lifelong
- Affordable: To families/individuals
- Sustainable: For society
- Health of population improves
A catchy acronym to remember it is: “U-CASH”
IOM Report: www.iom.edu/uninsured
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- Download Powerpoint presentations and more Fact Sheets and Handouts by CaHPSAnians.
Additional Resources
Use these many resources and web sites
Footnotes
- Lewin Group Report – Summary and full report: http://www.healthcareforall.org/studies.html
- http://www.calnurses.org/research/pdfs/ihsp_sp_economic_study_2009.pdf
- “Insuring America’s Health” (2004), Institute of Medicine. http://www.iom.edu/CMS/3809/4660/17632.aspx.>