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healthcare4every1.orgGet educated. Get talking.
Get active.
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What is Universal Health Care?

• Universal health care is high-quality health care
  that is affordable and available to all
  Connecticut residents.
• Universal health care is not socialized
  medicine. It is health care that is sustainable
  for society that includes business.
• It is actually less expensive than the patchwork
  system we have now. Economists estimate that
  covering everyone would SAVE the U.S. between
  320.5 billion and 1.1 trillion over a decade

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What could universal health care do for
micro-business in Connecticut?

• Level the playing field provide small and
  micro-businesses what large businesses have had
  high-quality, affordable health insurance
• Ability to attract quality, mature workers who
  need health insurance to protect their families.
  These workers can help a micro-business
  duplicate the owner and allow the owner to
  concentrate on selling and expanding the business
• Protect the business owners by providing the
  support for them to take care of their health and
  their employees health
• Reduce health care costs for all businesses who
  currently provide health insurance to their
  employees

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What if I dont provide health insurance now?
Will I be compelled to pay?

• The universal health care law hasnt been written
  yet, so we dont know what provisions will be
  made for small or micro-businesses
• The purpose of our current dialogue is to raise
  the issues that are real in your business
• In other states where universal health care has
  been passed, the concerns of micro-businesses
  were taken very seriously. Laws were designed to
  protect them from costs that were sudden and
  higher than they could afford.
• Its important to hear from you. What can you
  afford? How could access to affordable coverage
  help you and your family? How could it help your
  business?

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But we certainly cant afford the status
quoHealth care in Connecticut is in crisis

• The rate of growth is not sustainable
• Families cant afford increasing costs
• Small businesses cant afford the premiums and
  the unpredictable cost increases
• Health-related bankruptcies are skyrocketing
• Doctors and hospitals cant absorb any more
  uncompensated care
• The uninsured and underinsured are getting too
  little care too late at too high a price

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Our health care spending is not sustainable for
our economy
US health care total spending projections

• In 1980, national health expenditures were 8.8
  of Gross Domestic Product. By 2014 they are
  predicted to be 18.7
• It is estimated that if there is no change,
  health costs for businesses will overtake profits
  by 2008

Sources Mapping Health and Insurance Coverage in
CT, CMS
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Premium costs are out of reach for many

• From 2000 to 2004, CT workers health premiums
  grew by 56 while wages grew by only 14
• In 2005, the average least costly small business
  total premium was equal to 75 of the gross
  income of a full-time, minimum wage CT worker
• CT is the 6th most expensive state in the US for
  family health insurance premiums and 12th most
  expensive for individual coverage

Source AHRQ, Health Affairs, Lewin Group, OHCA
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Taxpayers pay for a large share of CTs health
care now
Sources of health spending, CT 2005
Source Mapping Health Spending and Insurance
Coverage in CT
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Our high level of uninsured residents increases
costs for all of us

• 365,000 CT residents are uninsured more than
  the combined populations of New Haven PLUS
  Hartford PLUS Waterbury PLUS Middletown
• The uninsured add inefficiencies that increases
  premiums 198 per year for CT individual coverage
  and 583 for CT families
• In 2005, Connecticut spent approximately 572
  million on direct health care costs for uninsured
  residents.
• Connecticut loses between 584 million and 1.164
  billion in increased morbidity and mortality
  because of preventable illness in the uninsured

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CTs Uninsured many work for small business

• Most are working people
• Most want coverage but cant afford it
• Many work for small businesses
• Many are young, age 19 to 29, often too old to
  remain on parents plan or HUSKY
• Many are near-elderly, age 55 to 64, hoping to
  stay well until they become eligible for Medicare

Source OHCA
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Any of us can lose our insurance at any time

• Many people are just a pink slip away from being
  uninsured
• People lose insurance when they
• Lose a job
• Graduate from school,
• Get married or divorced
• Suffer a major illness or accident

Source OHCA, IOM
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Being uninsured is bad for your health

• 18,000 Americans die needlessly every year
  because of health effects of being uninsured
  the 6th largest cause of death in the US
• CTs uninsured are 10 times less likely to get
  care for an injury and 7 times less likely to get
  care for a medical emergency
• 12 of hospital stays for the uninsured could
  have been prevented with early treatment
• While the uninsured use half as much health care
  as the rest of us, they pay far more out of
  pocket

Sources Health Affairs, IOM, Kaiser Commission,
Hewitt Assoc.s, Commonwealth Fund
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Even if youre covered, you can be under-insured

• If you are insured, you still have co-pays,
  deductibles, and co-insurance. Sometimes the
  services you need are not covered
• Half of all bankruptcies are due to high medical
  bills and most of those are among people who
  HAVE health insurance

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How can we evaluate universal health care
proposals?

• The Institute of Medicine (IOM) is led by some
  of the nations most respected doctors and
  academics. It provides unbiased, evidence-based
  information on the nations health.
• The IOMs five principles provide a tool for
  judging health care systems1.

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The IOM Principles

• Any plan insuring our health must be
• Universal no one is left out
• Continuous or portable it stays with you
  regardless of marital or employment status
• Affordable to individuals and families
  regardless of your economic circumstances
• Affordable and sustainable for society it works
  for, rather than against, our economy
• Better for our health and well-being it produces
  access to high-quality care for all

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We can afford to cover everyone

• Economists estimate that covering everyone would
  SAVE the US between 320.5 billion and 1.1
  trillion over a decade
• IOM estimates that the US economy loses 65 to
  130 billion each year in productivity due to
  workers lack of coverage

Sources Nat. Coalition on Health Care,
Washington Post, IOM
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The key is to create a large pool of people that
includes the healthy and the not-so-healthy

• Insurance premiums are based on the health care
  needs of the people who are in the pool
• The larger and more varied the health, age, and
  gender of the people in the pool, the more the
  risk is spread and the lower the cost for
  everyone in the pool
• When healthy people are taken out of the pool,
  people with more health needs and risks are left,
  and premiums get very expensive

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Options for Universal Health Care

• The Universal Health Care Foundation of
  Connecticut commissioned a study of Connecticuts
  existing health care situation and possible
  approaches to making it more equitable. The three
  plans outlined below are not intended to be the
  only possibilities for fixing our health care
  crisis. They are intended as a basis for
  exploring possible solutions.
• The study was done by the Economic and Social
  Research Institute (ESRI), the Urban Institute
  and the Massachusetts Institute of Technology
  (MIT) and was completed in 2006.

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Option 1 One Health Plan Serving All State
Residents

• All residents under 65 would be covered.
• A single health plan would cover all residents.
• Benefits would be similar to those offered by
  private employers.
• A commission would administer the plan.
• Individuals could buy supplemental insurance.

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How could we pay for Option 1?

• Federal matching funds under Medicaid and SCHIP
  would increase by 840 million.
• Contributions from employers and employees would
  help finance the fund.
• Employers who do not insure their workers today
  would have to pay for coverage through the plan.
  It would be important to find a way to work with
  small businesses to help them utilize the
  benefits of having insured workers, but without
  undue burden to them financially.
• The self-employed would make contributions based
  on income.

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Option 2 A State Pool With CompetingPrivate
Health Plans

• Every resident under age 65 would be covered.
• Those who do not have employer sponsored
  insurance would be enrolled in a choice of
  private insurance plans, with premiums based on
  income and coverage choices.
• An existing state agency or private contractor
  would administer the pool.
• HUSKY-eligible children and adults under 65 with
  incomes below 28,635 for a family of three would
  receive supplemental benefits to cover
  out-of-pocket expenses.
• Those working for companies that offer health
  plans would be automatically enrolled in them.

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How could we pay for Option 2?

• Annual health care spending would increase 30
  million one fifth of one percent.
• The health pool would be financed through
  existing state funds, individual premium
  payments, federal matching grants and businesses
  that dont offer health insurance.

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What are your insights and concerns about the
Options? How might they impact your business?

• What are the high-priority issues for you?
• Are you covered now? Do you have employees? Are
  they covered?
• What are the trade-offs for you? Are you covered
  by a spouses policy? How does that affect your
  familys choices?
• How would your business benefit if you could
  provide quality coverage?
• What would you be able or willing to pay to get
  quality coverage?
• What do you want your legislators to know about
  how affordable health coverage might impact your
  business?

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Other states are making bold change

• Massachusetts -- Bill signed by the Governor in
  2006 is a universal health care plan combining
  Medicaid expansion, employer contribution and
  mandate on individuals to secure coverage.
• Maine Dirigo Health created in 2003 to provide
  coverage to all Mainers by 2009. Provides
  affordable coverage to individuals and small
  businesses through a state partnership with
  Anthem. Saved 43.7 million in first year.
• Vermont Passed the 2006 Health Care
  Affordability Act that manages chronic care and
  makes health care affordable and accessible.

Sources States of MA, ME, IL, VT
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Where we are on this issue in Connecticut?

• Business organizations, Chambers of Commerce and
  others are dedicated to working on this issue
• Gubernatorial campaign is addressing it
• Legislative leadership and candidates
• CT Medical Society has strongly supported the
  concept
• Faith community is becoming involved
• Organized Labor has made universal health care a
  key issue
• People in communities across the state are
  becoming involved

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Learn More

• www.universalhealthct.org
• www.cthealthpolicy.org
• www.healthcare4every1.org
• The Politics of Universal Health Care in the New
  England States, Wednesday, October 18, 6 pm at
  the Sheraton Four Points Meriden. Order tickets
  at http//www.universalhealthct.org