Slide 1

Saving Medicare: Lessons from Canada

healthcare-now.orgpnhp.orgBenjamin DayDirector of OrganizingHealthcare-NOW!David Himmelstein, MDSteffie Woolhandler, MD, MPH Professors, CUNY School of Public HealthCo-Founders, PNHPJune 26, 2013Medicare Signed Into LawJuly 30th, 1965

2009 Medicare Trustees Report:Insolvency by 2018 ($billions)3Under ACA: Medicare Trust Fund Exhausted in 2026 (early as 2019)

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Graph source: Medicare Spending and Financing: A Primer, Kaiser Family Foundation, 2011.5U.S. Spends Almost Double Next Highest Spending Country

6U.S. Health Care System the Sixth Largest Economy in the WorldCountry2010 GDPUnited States$14,447,100China$5,739,358Japan$5,458,873Germany$3,280,334France$2,559,850U.S. Health Care System$2,542,690United Kingdom$2,253,552GDP estimates for 2010 from the United Nations; U.S. health care costs from OECD.http://unstats.un.org/unsd/snaama/dnltransfer.asp?fID=2http://www.oecd.org/document/60/0,3746,en_2649_33929_2085200_1_1_1_1,00.html

7Whats right about Medicare

Whats wrong Incomplete Coverage

Wealth MattersPlanning 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.

Whats wrong PrivatizationPubic money with private control:

Despite Medicares Lower Overhead, Enrollment of Medicare Patients in Private Plans Has Grown

Canadian Medicare- a true single payer1 Covers everything2- Covers everyone3 Public service model that restricts

Cost Control in a Parallel Universe:Growth in Medicare Spending Per Senior in the U.S. and Canada, 1980-2009Source: Himmelstein & Woolhandler, Arch Intern Med, December, 2012

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, 2012Take Action for Medicares Birthday, July 30, 2013!healthcare-now.orgpnhp.org1971-20090.99991198550.99999951761.03789377871.08257827451.12427525281.1725512751.17394922271.2562217481.187100921.30516357811.22850644221.38668622561.25859948541.43579307641.28118104041.4424391291.30925343341.47499458641.31643694131.56991422651.32735858011.61565474191.37119697371.66886092211.36949738431.78255441591.32758258631.88007520571.24891223311.98292067381.21377645382.12850688041.15894370062.22810247671.18294070612.31016021831.24976822362.25538443411.27998627952.18274016431.2909399132.16411820541.35824034922.30684781021.40597345152.43008570561.46165686212.46868262091.48984656582.60303589861.50957306682.6921050821.55713804672.753885821.56689648012.78582827721.54215053982.86050980231.64817144942.9869066261

CanadaU.S.YearChange in Medicare Cost/Senior (1980=1)

Sheet1U.S.CanadaUs - 1980 =1Canada - 1980 =11971$1,992.414,9301972$2,079.145,1691973$2,036.075,1341974$2,193.145,1231975$2,444.685,6271976$2,652.265,7481977$2,844.545,7631978$2,936.875,7361979$3,011.755,6021980$3,162.635,638$1.000.99991198551981$3,423.795,852$1.081.03789377871982$3,708.356,339$1.171.12427525281983$3,972.966,619$1.261.17394922271984$4,127.756,693$1.311.187100921985$4,385.586,926$1.391.22850644221986$4,540.887,096$1.441.25859948541987$4,561.907,223$1.441.28118104041988$4,664.867,382$1.471.30925343341989$4,965.067,422$1.571.31643694131990$5,109.727,484$1.621.32735858011991$5,277.997,731$1.671.37119697371992$5,637.567,721$1.781.36949738431993$5,945.987,485$1.881.32758258631994$6,271.247,041$1.981.24891223311995$6,731.686,843$2.131.21377645381996$7,046.666,534$2.231.15894370061997$7,306.186,669$2.311.18294070611998$7,132.957,046$2.261.24976822361999$6,903.207,217$2.181.27998627952000$6,844.317,278$2.161.2909399132001$7,295.717,658$2.311.35824034922002$7,685.467,927$2.431.40597345152003$7,807.538,241$2.471.46165686212004$8,232.448,400$2.601.48984656582005$8,514.138,511$2.691.50957306682006$8,709.528,779$2.751.55713804672007$8,810.548,834$2.791.56689648012008$9,046.738,695$2.861.54215053982009$9,446.489,292$2.991.64817144942010$9,306.33

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