1. Saving Medicare: Lessons from Canada healthcare-now.org pnhp.org Benjamin Day Director of Organizing Healthcare-NOW! Steffie Woolhandler, MD, MPH Professor, CUNY School of Public Health Co-Founder, PNHP June 26, 2013

2. Medicare Signed Into Law July 30th, 1965 3. 2009 Medicare Trustees Report: Insolvency by 2018 ($billions) $601 $701 $835 $592 $784 $926 $371 $224 $59 $0 $100 $200 $300 $400 $500 $600 $700 $800 $900 $1,000 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Income Expenditures Assets 4. Under ACA: Medicare Trust Fund Exhausted in 2026 (early as 2019) 5. Graph source: Medicare Spending and Financing: A Primer, Kaiser Family Foundation, 2011. 6. U.S. Spends Almost Double Next Highest Spending Country 7. U.S. Health Care System the Sixth Largest Economy in the World Country 2010 GDP United States $14,447,100 China $5,739,358 Japan $5,458,873 Germany $3,280,334 France $2,559,850 U.S. Health Care System $2,542,690 8. Whats right about Medicare 9. Whats wrong Incomplete Coverage 10. Wealth Matters Planning for Retirement? Dont Forget Health Care Costs Medicare . . . Covers only 51% of health care services. . . . For a 65 year old couple retiring this year, the cost of health care in retirement will be $240,000. 11. Whats wrong Privatization Public money with private control : 12. Despite Medicares Lower Overhead, Enrollment of Medicare Patients in Private Plans Has Grown 13. Canadian Medicare- a true single payer 14. 1 1.5 2 2.5 3 1980 1984 1988 1992 1996 2000 2004 2008 Year ChangeinMedicareCost/Senior(1980=1) Canada U.S. Cost Control in a Parallel Universe: Growth in Medicare Spending Per Senior in the U.S. and Canada, 1980-2009 Source: Himmelstein & Woolhandler, Arch Intern Med, December, 2012 15. How Has Canada Controlled Costs? Lower administrative cost - 16.7%v 31.0% (U.S.) Lump-sum, global budgets for hospitals with stringent capital control of new buildings and equipment Single buyer purchasing reins in drug/device prices Exclusion of private insurers - private plans overcharged U.S. Medicare by $34 billion in 2012 Source: Himmelstein & Woolhandler, Arch Intern Med, December, 2012 16. Take Action for Medicares Birthday, July 30, 2013! healthcare- now.orgpnhp.org