Health InsuranceHealth Insurance

Shannon HarrShannon HarrCamille Pane, MDCamille Pane, MD

Chris MaherChris MaherLauren O’ConnorLauren O’Connor

Tom MillerTom Miller

OverviewOverview

InsuranceInsurance History of National Health InsuranceHistory of National Health Insurance HR 676HR 676 Healthy Americans ActHealthy Americans Act Florida Quality Care ActFlorida Quality Care Act

InsuranceInsurance

Insurance: Insurance: A contract (policy) in which an A contract (policy) in which an

individual or entity receives financial individual or entity receives financial protection, or reimbursement, against protection, or reimbursement, against losses from an insurance company, losses from an insurance company, which pools clients’ risks to make which pools clients’ risks to make payments more affordable, in exchange payments more affordable, in exchange for a premium. for a premium.

Cost-SharingCost-Sharing

Pool Pool money money togethertogether

““Share Share the risk”the risk”

Delivery & Financing: Delivery & Financing: Self-PaySelf-Pay

Patients

Payment

ServicesProviders

Patients

3rd PartyPayers

ProvidersServices

Payment(Deductibles, coinsurance, copays)

Prem

ium

s & T

axes

Ins.

Covera

ge

Payments For

Covered ServicesClaims

Delivery & Financing: 3Delivery & Financing: 3rdrd PartyParty

What does all this What does all this ReallyReally Mean?Mean?

Premium:Premium: Amount YOU pay every month Amount YOU pay every month Ex: You pay $250 every month for your Ex: You pay $250 every month for your

insurance planinsurance plan Deductible:Deductible: Amount YOU pay after Amount YOU pay after

receiving a service, up to a specified receiving a service, up to a specified yearly maximumyearly maximum Ex: Procedure costs $1000, you pay $500Ex: Procedure costs $1000, you pay $500

Coinsurance:Coinsurance: % YOU pay after receiving % YOU pay after receiving a servicea service Ex: Procedure costs $1000, you pay 30% or Ex: Procedure costs $1000, you pay 30% or

$300$300 Copayment:Copayment: Amount YOU pay Amount YOU pay every timeevery time

you are seen by a provideryou are seen by a provider

Insurance: Who is Insurance: Who is Paying?Paying?

Government Health Government Health InsuranceInsurance

Government Health InsuranceGovernment Health Insurance MedicareMedicare MedicaidMedicaid Military health careMilitary health care

TRICARE/CHAMPUS TRICARE/CHAMPUS CHAMPVACHAMPVA The Department of Veterans Affairs (VA)The Department of Veterans Affairs (VA)

SCHIPSCHIP State-specific planState-specific plan Indian Health ServiceIndian Health Service

Private Health InsurancePrivate Health Insurance

Private Health InsurancePrivate Health Insurance Employment-based plans Employment-based plans Direct-purchase planDirect-purchase plan

Managed CareManaged Care HMO HMO PPOPPO POSPOS

47 M Uninsured47 M Uninsured

History: National Health History: National Health InsuranceInsurance

(1974) President Nixon introduced a (1974) President Nixon introduced a National Health Insurance ProgramNational Health Insurance Program Employers would be required to provide Employers would be required to provide

private insurance for their employees, a private insurance for their employees, a separate government system would provide separate government system would provide the same benefits for the rest of the the same benefits for the rest of the population.population.

Watergate scandal diverted focusWatergate scandal diverted focus Ford withdrew the administration's plan Ford withdrew the administration's plan

saying it would make inflation worse.saying it would make inflation worse.

History: National Health History: National Health Insurance Continued…Insurance Continued…

(1993) Clinton Plan(1993) Clinton Plan Envisioned creating large regional Envisioned creating large regional

purchasing alliances that would enroll purchasing alliances that would enroll public and private employees, the self-public and private employees, the self-employed, the unemployed, and employed, the unemployed, and Medicare and Medicaid patients.Medicare and Medicaid patients.

1,364 page bill was very complicated 1,364 page bill was very complicated and it was bad timing with regards and it was bad timing with regards to the marketsto the markets

Universal CoverageUniversal Coverage Personal mandates and subsidies Personal mandates and subsidies

Every American have health insurance that meets Every American have health insurance that meets some minimum standard, the gvnt. provides some minimum standard, the gvnt. provides subsidies or tax credits to the poor to enable them subsidies or tax credits to the poor to enable them to purchase insurance to purchase insurance

Single-payer Single-payer Imagine Medicare extended to cover all age groups Imagine Medicare extended to cover all age groups

but includes coverage for dental services, long-but includes coverage for dental services, long-term care, prescription drugs, and more term care, prescription drugs, and more comprehensive mental health care. comprehensive mental health care.

Universal Vouchers Universal Vouchers Combines publicly funded social insurance for Combines publicly funded social insurance for

basic care with competition. Individuals and basic care with competition. Individuals and families would have free choice of plans and families would have free choice of plans and freedom to purchase additional services with their freedom to purchase additional services with their own after-tax dollarsown after-tax dollars. .

HR 676HR 676110th Congress110th Congress

““A bill to provide for comprehensive A bill to provide for comprehensive health insurance coverage for all health insurance coverage for all United States residents, and for United States residents, and for

other purposes.”other purposes.”

SponsorsSponsors

Introduced by John Conyers, D-MI Introduced by John Conyers, D-MI Other sponsors:Other sponsors:

KucinichKucinich RangelRangel

EligibilityEligibility

All residents of the U.S. and its All residents of the U.S. and its territoriesterritories

No mention is made of legal/illegal No mention is made of legal/illegal immigrant statusimmigrant status

Individuals will be presumed eligible if they Individuals will be presumed eligible if they present for services, but will then need to present for services, but will then need to complete an applicationcomplete an application

BenefitsBenefits

Primary care & preventionPrimary care & prevention Inpatient & outpatient careInpatient & outpatient care Emergency careEmergency care Prescription drugsPrescription drugs DMEDME Long term careLong term care Mental health & substance abuse Mental health & substance abuse

servicesservices Dental care (non-cosmetic)Dental care (non-cosmetic) Chiropractic careChiropractic care Vision care & correctionVision care & correction Hearing services including hearing aidsHearing services including hearing aids

Benefits/PortabilityBenefits/Portability Benefits available anywhere in the Benefits available anywhere in the

U.S. through licensed cliniciansU.S. through licensed clinicians No deductibles, copayments, No deductibles, copayments,

coinsurancecoinsurance Private insurers may not sell Private insurers may not sell

coverage that duplicates the basic coverage that duplicates the basic benefit packagebenefit package

Insurers may, however, sell plans Insurers may, however, sell plans that provide benefits not offered that provide benefits not offered through the basic benefit package through the basic benefit package

BudgetBudget Operating budgetOperating budget

Clinician payments (FFS)Clinician payments (FFS) Global budgets for institutional providersGlobal budgets for institutional providers Capitation paymentsCapitation payments Administrative costsAdministrative costs

Capital expendituresCapital expenditures Construction/renovation of health facilitiesConstruction/renovation of health facilities Major equipment purchasesMajor equipment purchases

Health professional education budgetHealth professional education budget

FundingFunding

Existing sources of revenue for Existing sources of revenue for health care health care

Increasing personal tax on top 5% Increasing personal tax on top 5% income earnersincome earners

Modest & progressive excise tax on Modest & progressive excise tax on payroll/self-employment incomepayroll/self-employment income

Small tax on stock/bond transactionsSmall tax on stock/bond transactions

Funding continuedFunding continued

System savings will provide huge System savings will provide huge amounts of $$amounts of $$ Significantly reduced overheadSignificantly reduced overhead Monopsony purchasing power for Monopsony purchasing power for

medicationsmedications

The Healthy The Healthy Americans Act of Americans Act of

20072007……guarantees  universal,  private guarantees  universal,  private

 health   health  

insurance  for  ALL Americans.insurance  for  ALL Americans.

Sponsor:Sponsor:

Senator Ron Wyden (D, OR)Senator Ron Wyden (D, OR)- Senator since 1996Senator since 1996- Served 15 years in U.S. House of Served 15 years in U.S. House of

RepresentativesRepresentatives

What is HAA?What is HAA?

A new system in which every A new system in which every American will have the power to American will have the power to choose a comprehensive, private choose a comprehensive, private health insurance plan in the state of health insurance plan in the state of their residency. their residency.

The insurance will be high-quality yet The insurance will be high-quality yet affordable for every American.affordable for every American.

Even if they change, lose, or become Even if they change, lose, or become too sick to work at their job, too sick to work at their job, Americans will always have care.Americans will always have care.

How does HAA work?How does HAA work?

The Healthy Americans Act matches insurers with The Healthy Americans Act matches insurers with health care consumers in a competitive health care consumers in a competitive environment.environment. This competition should drive down pricesThis competition should drive down prices

Each state will establish a Health Help Agency Each state will establish a Health Help Agency (HHA)(HHA) These HHAs will lower admin costsThese HHAs will lower admin costs Also provide unbiased information about competing Also provide unbiased information about competing

private health insurance plansprivate health insurance plans Determine premium reductions Determine premium reductions

With these resources, individuals will be able to With these resources, individuals will be able to choose which works best for them and their choose which works best for them and their families.families.

Government’s Government’s Responsibility:Responsibility:

Ensure every American has and can Ensure every American has and can afford health insurance:afford health insurance: Through the Health Help AgenciesThrough the Health Help Agencies Lower premiums and tax deductionsLower premiums and tax deductions Individuals will need to verify their Individuals will need to verify their

enrollmentenrollment Done through interaction with state, local, Done through interaction with state, local,

and federal governmentand federal government

Eligibility:Eligibility:

All Americans will be covered:All Americans will be covered: Individual mandate will be implementedIndividual mandate will be implemented Must purchase one of the options given by Must purchase one of the options given by

the state of residencythe state of residency Menu of health insurance plansMenu of health insurance plans Coverage must be equal or greater than BC/BS Coverage must be equal or greater than BC/BS

Standard Plan used by CongressStandard Plan used by Congress Previous and existing conditions, Previous and existing conditions,

occupation, genetic information, gender and occupation, genetic information, gender and age will age will NOTNOTimpact eligibility or price paid for impact eligibility or price paid for insurance.insurance.

BenefitsBenefits Primary carePrimary care Inpatient & outpatient careInpatient & outpatient care Emergency careEmergency care Prescription drugsPrescription drugs DMEDME Mental health & substance abuse servicesMental health & substance abuse services Dental care (non-cosmetic)Dental care (non-cosmetic) Chiropractic careChiropractic care Vision care & correctionVision care & correction Hearing services including hearing aidsHearing services including hearing aids Wellness and preventionWellness and prevention

Not covered:Not covered: Long-term careLong-term care

How is the insurance How is the insurance Affordable?Affordable?One way is to put more money in One way is to put more money in

people’s pockets:people’s pockets: During first two years, employers who During first two years, employers who

currently provide health benefits will currently provide health benefits will convert it to higher wages.convert it to higher wages.

Employees will use the increase to Employees will use the increase to purchase their own private health purchase their own private health insuranceinsurance

How is the insurance How is the insurance Affordable?Affordable?

For employers who currently do not For employers who currently do not provide health benefits:provide health benefits: Required to pay “Employer Shared Required to pay “Employer Shared

Responsibility Payments” (ESRPs)Responsibility Payments” (ESRPs) After the initial two years, ALL employers After the initial two years, ALL employers

will be required to pay the ESRPs.will be required to pay the ESRPs. These payments will reflect the ability to These payments will reflect the ability to

pay according size and type of industrypay according size and type of industry

What’s wrong with this?What’s wrong with this?

Other Types of Funding:Other Types of Funding:

Subsidies will be offered:Subsidies will be offered: Varying up to 400% above the poverty Varying up to 400% above the poverty

lineline Full coverage provided to those below Full coverage provided to those below

100%100%

Employers will contribute through a Employers will contribute through a set equation related to business size set equation related to business size and yearly profits.and yearly profits.

Incentives and RewardsIncentives and Rewards

Gives insurers financial incentives:Gives insurers financial incentives: Have them invest in prevention and disease Have them invest in prevention and disease

management management Will give individuals more reason to choose their plans, to Will give individuals more reason to choose their plans, to

keep healthy, and stay with the same insurerkeep healthy, and stay with the same insurer What if large numbers of individuals leave the state?What if large numbers of individuals leave the state?

Rewards individuals and their families when they Rewards individuals and their families when they participate in wellness programsparticipate in wellness programs Reduce the monthly premiumsReduce the monthly premiums

Rewards providers for helping their patients stay Rewards providers for helping their patients stay healthy healthy

Cost Containment:Cost Containment:Competition will drive down costs and promote quality.Competition will drive down costs and promote quality.

Taxpayers will not be asked to foot the bill for expensive visits to Taxpayers will not be asked to foot the bill for expensive visits to the emergency room, because:the emergency room, because: Every individual has adequate coverageEvery individual has adequate coverage They will use prevention and wellness servicesThey will use prevention and wellness services

Ultimately, the average growth in health care spending will slow by Ultimately, the average growth in health care spending will slow by 0.86% between 2007-2016.0.86% between 2007-2016. Results in savings of $1.48 trillion.Results in savings of $1.48 trillion.

Did I miss something?Did I miss something?Average increase in annual rate of health care spending = around Average increase in annual rate of health care spending = around

10%10%Will slow by 0.86% b/w 2007-2016… so will be equal to 9.14% in Will slow by 0.86% b/w 2007-2016… so will be equal to 9.14% in

20162016Yet individuals still have wage raises (after the initial spike) of Yet individuals still have wage raises (after the initial spike) of

about 3% annuallyabout 3% annually

Proposed LegislationProposed Legislation

Florida Quality Care Florida Quality Care ActAct

--Group coverage for Group coverage for Floridians until National Floridians until National

Health Insurance or HR 676 Health Insurance or HR 676 implementedimplemented

Call to ActionCall to Action

To stay relevant, Republicans must:To stay relevant, Republicans must: Recognize that universal health Recognize that universal health

coverage is necessarycoverage is necessary Come up with a reasonable and rational Come up with a reasonable and rational

planplan Stay true to the values of:Stay true to the values of:

Personal responsibility and accountabilityPersonal responsibility and accountability Fiscal Responsibility and accountabilityFiscal Responsibility and accountability The importance of the individualThe importance of the individual

Out of Necessity…Out of Necessity…

Due to existing laws (EMTALA, etc.) Due to existing laws (EMTALA, etc.) the burden of the uninsured the burden of the uninsured continually falls on hospitals and continually falls on hospitals and physiciansphysicians

Not cost-effective or a reasonable Not cost-effective or a reasonable allocation of resourcesallocation of resources

……Comes InnovationComes Innovation

Require that everyone in the State of Require that everyone in the State of Florida have health insuranceFlorida have health insurance

Subsidize the insurance for the Subsidize the insurance for the working poorworking poor

Use Florida’s most abundant natural Use Florida’s most abundant natural resource (tourists) to be the primary resource (tourists) to be the primary funding for this programfunding for this program

But is it Republican?But is it Republican?

BENEFITSBENEFITS Coverage for deserving Coverage for deserving

and eligible Floridiansand eligible Floridians Resurgence of the Resurgence of the

small to mid-sized small to mid-sized business sectorbusiness sector

Rewards capitalism and Rewards capitalism and competition competition

Self-reliance & freedom Self-reliance & freedom of choiceof choice

Emphasizes Emphasizes responsibility and responsibility and accountabilityaccountability

COSTSCOSTS Citizenship requirement Citizenship requirement

(keeping with R. values)(keeping with R. values) Coverage is limited to Coverage is limited to

allow for universal allow for universal provision but can be provision but can be augmented based on augmented based on individual contributionsindividual contributions(choices still remain)(choices still remain)

Private health insurance Private health insurance & drug companies could & drug companies could feel a squeezefeel a squeeze(Or would they?)(Or would they?)

Target GroupsTarget Groups

Who to Draw In?Who to Draw In?

1.1. Small to mid-sized Small to mid-sized business owners & business owners & employeesemployees

2.2. Working Working Americans on Americans on Cusp- no handouts Cusp- no handouts but sense of having but sense of having earned right to earned right to healthcarehealthcare

Who not to isolate ($Who not to isolate ($$$)$$)

1.1. Big PharmaBig Pharma

2.2. Private Health Private Health Insurance Insurance CompaniesCompanies

Handling Big PharmaHandling Big Pharma

Emphasize that lower prices Emphasize that lower prices throughout industry doesn’t mean throughout industry doesn’t mean less incomeless income

1.1. More insured= more medication/rx’sMore insured= more medication/rx’s

2.2. Better coverage reduces need for Better coverage reduces need for genericsgenerics

3.3. Kick-backs for research endeavors Kick-backs for research endeavors (i.e., focus on science, not marketing)(i.e., focus on science, not marketing)

4.4. Blame CanadaBlame Canada

Private Insurance Co’sPrivate Insurance Co’s Private insurance is not eliminated:Private insurance is not eliminated:1.1. Insurance is required for all Floridians.Insurance is required for all Floridians.2.2. Florida coverage is optional for those Florida coverage is optional for those

eligible but those who choose/prefer eligible but those who choose/prefer private insurance can still have it.private insurance can still have it.

3.3. Private insurance can actually expand by Private insurance can actually expand by focusing on benefits not covered by focusing on benefits not covered by statewide insurance system (ie. statewide insurance system (ie. cosmetic, preventative care etc…).cosmetic, preventative care etc…).

4.4. Become health investment sources for Become health investment sources for HSA, LTCSA and investment options.HSA, LTCSA and investment options.

Long Live the Long Live the Entrepreneurial SpiritEntrepreneurial Spirit

EmployersEmployers Relieves burden from Relieves burden from

those who can’t afford to those who can’t afford to offer private insurance offer private insurance for all employeesfor all employees

Employee contributions Employee contributions and freedom of choice and freedom of choice eliminates the employer eliminates the employer “bad guy” perception“bad guy” perception

Healthier workers are Healthier workers are more productive more productive workersworkers

More quality employees More quality employees to smaller sector as to smaller sector as benefit gap diminishesbenefit gap diminishes

EmployeesEmployees Continued coverage for Continued coverage for

self and family reduces self and family reduces unemployment fearsunemployment fears

Choose occupations Choose occupations based on based on motivation/education, motivation/education, not benefit packagesnot benefit packages

Customization and Customization and personal contributions personal contributions allow for independent allow for independent need and long-term need and long-term care contributioncare contribution

Your $ doesn’t die with Your $ doesn’t die with youyou

Plan SummaryPlan Summary

Provide statewide health insurance Provide statewide health insurance coverage for the working poor.coverage for the working poor. $200 individual deductible, max $400/family to $200 individual deductible, max $400/family to

offset costs and prevent abuseoffset costs and prevent abuse Graduate student tax deductions in amount of Graduate student tax deductions in amount of

deductible to encourage higher educationdeductible to encourage higher education Freedom to choose facility and provider with Freedom to choose facility and provider with

specialist exception (recommendation specialist exception (recommendation required)required)

FeaturesFeatures No Cards= Government invasion of privacy No Cards= Government invasion of privacy

(FL license, ID or birth certificate is enough)(FL license, ID or birth certificate is enough) General benefits include 1 annual dental General benefits include 1 annual dental

cleaning & medically necessary dental work, cleaning & medically necessary dental work, 2 year vision screening and 1 pair 2 year vision screening and 1 pair prescription glasses, mental health treatment prescription glasses, mental health treatment and counseling, all physical health needs done and counseling, all physical health needs done through private physicians (ER visits only as through private physicians (ER visits only as necessary).necessary).

Vaccination coverageVaccination coverage 80% prescription coverage (rest covered by 80% prescription coverage (rest covered by

HSA etc…)HSA etc…)

Features Cont…Features Cont…

Freedom to contribute to HSA Freedom to contribute to HSA accountaccount

Freedom to contribute to LTCSAFreedom to contribute to LTCSA Freedom to invest in stock market Freedom to invest in stock market

with capital gains exemptions up to with capital gains exemptions up to bracket allowances (brackets based bracket allowances (brackets based on age, dependents, income)on age, dependents, income)

More Ideas to Incorporate – More Ideas to Incorporate – Individual Funding & Individual Funding &

ContributionsContributions HSA AccountsHSA Accounts

annual rolloverannual rollover portableportable

LTCSALTCSA tax exempttax exempt PortablePortable TrustTrust 10 year max (C.O.L 10 year max (C.O.L

increases)increases)

Encourage Market Encourage Market InvolvementInvolvement allow tax exempt allow tax exempt

investmentsinvestments

More Ideas – Financial More Ideas – Financial Benefits for Organizations Benefits for Organizations

InvolvedInvolved Limits on liability for health industryLimits on liability for health industry

Limits on malpractice premiums for Limits on malpractice premiums for health workershealth workers

Financial rewards and tax breaks for Financial rewards and tax breaks for biomedical researchbiomedical research

Show Me the MoneyShow Me the Money

How is it going to get paid for?How is it going to get paid for?

This plan must be distinctly This plan must be distinctly Floridian…Floridian…

Therefore, we use Florida’s most Therefore, we use Florida’s most abundant natural resource; which is abundant natural resource; which is what?what?

TouristsTourists

They come to FL with bags full of They come to FL with bags full of money just itching to spend it.money just itching to spend it.

In fact, they spent about $62 Billion In fact, they spent about $62 Billion in 2005.in 2005.

More Ideas – Consumption-More Ideas – Consumption-Based FundingBased Funding

In keeping with the spirit of In keeping with the spirit of Florida’s tax system, all funding for Florida’s tax system, all funding for this program will come from this program will come from consumption taxesconsumption taxes 2 cent gas tax2 cent gas tax Toll increasesToll increases Increased luxury taxIncreased luxury tax

Terms:Terms: Moral hazardMoral hazard refers to the possibility that the redistribution of risk (such as refers to the possibility that the redistribution of risk (such as

insurance which transfers risk from the insured to the insurer) changes insurance which transfers risk from the insured to the insurer) changes people's behavior. For example, a person whose has health insurance will be people's behavior. For example, a person whose has health insurance will be less likely to prevent health problems (e.g.: drink and party too much) because less likely to prevent health problems (e.g.: drink and party too much) because they know the insurance will cover any medical expenses.they know the insurance will cover any medical expenses.

Adverse selectionAdverse selection refers to a market process in which bad results occur due refers to a market process in which bad results occur due to information asymmetries between buyers and sellers: the "bad" products or to information asymmetries between buyers and sellers: the "bad" products or customers are more likely to be selected. For example, if health insurance customers are more likely to be selected. For example, if health insurance rates increase, healthy people drop coverage and sick people will keep the rates increase, healthy people drop coverage and sick people will keep the insurance causing the pool of insured to only be sick people.insurance causing the pool of insured to only be sick people.

With “With “community ratingcommunity rating," everyone pays the same premium. An insurer ," everyone pays the same premium. An insurer using community rating to set insurance premiums ignores any differences in using community rating to set insurance premiums ignores any differences in expected costs among insured groups or people. If an insurer uses community expected costs among insured groups or people. If an insurer uses community rating, but people know and use their expected costs to decide whether or not rating, but people know and use their expected costs to decide whether or not to buy insurance, then only the sickest people may wind up signing up for to buy insurance, then only the sickest people may wind up signing up for insurance.insurance.

Under "Under "modifiedmodified" " community ratingcommunity rating, price differences could be based on age , price differences could be based on age and sex. The remainder of the definition will be the same as regular community and sex. The remainder of the definition will be the same as regular community rating. rating.

ReferencesReferences Fuchs, Emanuel. "Health Care Reform: Why? Fuchs, Emanuel. "Health Care Reform: Why?

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Mahar, Maggie. Mahar, Maggie. Money Driven MedicineMoney Driven Medicine. New . New York, NY: HarperCollins, 2006.York, NY: HarperCollins, 2006.

Tourism's Impact on Florida May be Greater than we Tourism's Impact on Florida May be Greater than we Know. Know. Florida TaxWatch. March 8, 2007. . March 8, 2007.

Florida Florida TaxWatch. 28 Mar 2007 TaxWatch. 28 Mar 2007

ReferencesReferences ““HAA How It Works.” HAA How It Works.” U.S. Senate WebsiteU.S. Senate Website 2006. U.S. 2006. U.S.

Senate. 26 Mar 2007 Senate. 26 Mar 2007

<http://wyden.senate.gov/Healthy_Americans_Act/<http://wyden.senate.gov/Healthy_Americans_Act/HAA_How_It_Works.pdf>HAA_How_It_Works.pdf>

Klein, Ezra. “The Healthy Americans Act.” Klein, Ezra. “The Healthy Americans Act.” The The American ProspectAmerican Prospect 2006. Prospect Online. 25 Mar 2006. Prospect Online. 25 Mar 20072007

<http://www.prospect.org/weblog/2006/12/<http://www.prospect.org/weblog/2006/12/post_2260.html>post_2260.html>

““MA Health Care Reform Law of 2006!.” MA Health Care Reform Law of 2006!.” Affordable Affordable Care TodayCare Today 2006. ACT Website. 27 Mar 2007 2006. ACT Website. 27 Mar 2007

<http://www.hcfama.org/act/mahealthreformlaw.asp><http://www.hcfama.org/act/mahealthreformlaw.asp>

ReferencesReferences Physicians for a National Health Program. Single Payer Physicians for a National Health Program. Single Payer

FAQ. Retrieved via FAQ. Retrieved via http://www.pnhp.org/facts/singlepayer_faq.php?page=allhttp://www.pnhp.org/facts/singlepayer_faq.php?page=all on on March 5, 2007March 5, 2007

Woolhandler, S., Himmelstein, D.U. National Health Woolhandler, S., Himmelstein, D.U. National Health Insurance: Liberal Benefits, conservative Spending. Insurance: Liberal Benefits, conservative Spending. Retrieved from Connecticut Coalition for Universal Health Retrieved from Connecticut Coalition for Universal Health Care via Care via http://cthealth.server101.com/national_health_insurance.hthttp://cthealth.server101.com/national_health_insurance.htmm on March 5, 2007 on March 5, 2007

Enthoven, A.C., Fuchs, V.R. Employment-Based Health Enthoven, A.C., Fuchs, V.R. Employment-Based Health Insurance: Past, Present and Future. Insurance: Past, Present and Future. Health AffairsHealth Affairs. 2006: . 2006: 25(6); 1538-1547. 25(6); 1538-1547.

Blumenthal, D. Employer-Sponsored Health Insurance in Blumenthal, D. Employer-Sponsored Health Insurance in the United States--Origins and Implications. the United States--Origins and Implications. NEJMNEJM. 2006: . 2006: 355(1); 82-88.355(1); 82-88.