Health and Health Care -...
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Transcript of Health and Health Care -...
Purpose of Presentation
To address the negative financial, social and personal consequences
That result from lacking health insurance and health care access.
To call your organization to action
What is Health?
Health is the absence of disease and attainment of well-being.
Health care is the activities related to keeping community members healthy, preventing disease progression, and treating the sick.
What is our health care system?
Emergency careHigh technology Life-prolongingPrescriptionsCutting-edgeExpensiveDifficult to access for prevention
Influencers of Health1. Behaviors and decisions that
affect individuals and families2. Decisions made by community
leaders regarding resources, promotion, and protection
3. Environment within the community that supports and facilitates healthful decisions
United Health Foundation – www.unitedhealthfoundation.org/shr2003/index.html
Health StatisticsUnited States
290,000,000 People $1.6 Trillion Expenditures For Health Care$5,440 per person average spending 9.3% Increase in spending in 2002 (mostly RX and hospital)
43 Million Uninsured
Kaiser Foundation Report: “Cost of not covering the uninsured”Sunherald.com Hospital spending and Rx
Health StatisticsCharlotte/Mecklenburg, NC
746,000 population17% uninsured120,000 people uninsured
Apprx : Mecklenburg County Health Dept 2002-NC DHHS/State Center for Health Statistics
Causes of DeathCost of Choice
Smoking#1 cause of preventable death
Obesity#2 cause of preventable death$2.1 Billion obesity and related illnesses$428 Million in Mecklenburg
Prevention Partners
Causes of DeathCharlotte/Mecklenburg, NC
1,100 Heart Disease1,000 Cancer350 Stroke/CVD207 Chronic Lower Respiratory
204 Accidental Injuries144 Alzheimer’s 114 Diabetes100 FluOther
Apprx : Mecklenburg County Health Dept 2002 Nation closely resembles local statistics
Approx. 4,600 Deaths Per Year
Behaviors, Decisions & Health
If80% of diseases are preventable
CouldA 50% reduction preventable diseases
TherebyReduce health care costs by 50%
?
2. Medicaid
Less than age 18 Older than 65Specially Qualified
PregnantDisabledBlind
Not an automatic safety-net for the poor
$4,000 annual income does not necessarily qualify for MA
2004 HHS Poverty Guidelines
Size of Family
Unit
February 2003
Guidelines 125% 150% 185% 200%1 9,310$ 11,638$ 13,965$ 17,224$ 18,620$ 2 12,490$ 15,613$ 18,735$ 23,107$ 24,980$ 3 15,670$ 19,588$ 23,505$ 28,990$ 31,340$ 4 18,850$ 23,563$ 28,275$ 34,873$ 37,700$ 5 22,030$ 27,538$ 33,045$ 40,756$ 44,060$ 6 25,210$ 31,513$ 37,815$ 46,639$ 50,420$ 7 28,390$ 35,488$ 42,585$ 52,522$ 56,780$ 8 31,570$ 39,463$ 47,355$ 58,405$ 63,140$
3. Private InsuranceEmployer provided – Not mandatedTrends:
Decreasing coverage in large businessIncrease co-pay/deductibleInability of small business to afford to offer coverageIncrease in businesses that will not offer coverageEliminating non-employee coverage spouse, child, partner, etc.
Insurance Coverage for Non-Elderly Population 2002
Employer sponsored
64%
Private non-group5%
Medicaid14%
Uninsured17%
Source: Kaiser Commission on Medicaid and the Uninsured
Fact About the Uninsured
•8 out of 10 are from working families
•70% have one or more full-time workers
•Near poor have greatest risk of becoming uninsured (<200% Federal Poverty Level)
•64% of the uninsured are low-income individuals or from low-income families
•80% are American citizens
•Trend of un insurance is increasing; especially in small businesses
Ages of the Uninsured 2002Non Medicare -- United States
Adults 55-64 Under age
19
Adults 19-34
Adults 35-54
Source: Kaiser Commission on Medicaid and the Uninsured and Urban Institute on March 2003 Current Population survey
Income of the Uninsured 2002 Non Medicare -- United States
200-299%FPL 300% FPL +
<100% FPL
100-199% FPL
Source: Kaiser Commission on Medicaid and the Uninsured and Urban Institute on March 2003 Current Population survey
Work Status of the Uninsured 2002Non Medicare -- United States
No Workers
1 Full-time
2 + Full-time
Part-time workers
Source: Kaiser Commission on Medicaid and the Uninsured and Urban Institute on March 2003 Current Population survey
UninsuredLength of Time -- United States
6-12 mo25%
>12 mo53%
�
< 6 mo22%
Anytime in one year 49 millionSource: Kaiser Commission on Medicaid and the Uninsured
26 million 11 million
12 million
Uninsured-Information
Less prevention Higher acuity Higher mortality rateLower earnings
Costly late stage treatment5-15% increased mortality than insured10-30% reduction in earnings and educationKaiser Commission on the Uninsured 2003
• 43 Million People Nationally• 10% Growth 2000-2002• One in Seven Americans
UninsuredCost of office-care versus hospitalizations
Bacterial pneumoniaDiabetes complicationsCongestive heart failureLow birth weightAdult asthma complications
HCC Research
12% of hospital costs of caring for uninsured are a result preventable complications
Questions of economic benefit to government and individuals
Uninsured average $1,253/year and receive ½ as much careInsured average $2,484$35 Billion in uncompensated care, $30 Billion is government paid
Kaiser Commission 6/03 report
Covering the UninsuredCost to increase coverage
+$34 B public standard coverage or+$69 B private standard coverage
Added to total current $99 BTotals $133 B to $168 B
Added to 1.6 Trillion currently spent
Overall impact 3-6% increase in total health care spending
Kaiser Commission 6/03
Uninsured- Providing CareCommunity Health ServicesMedAssistCharlotte Community Health ClinicUNCC Center for Health PromotionFree clinics of Our Towns
Metrolina Community Health Center Volunteer In Medicine Clinics Project Health ShareMecklenburg County Medical SocietyUNCCCarolinas Medical
Purpose of Presentation
To address the negative financial, social and personal consequences
That result from lacking health insurance and health care access.
To call your organization to action
What Can You Do?
Know where to refer someoneKnow issuesInfluence legislatorsSupport community efforts
ClinicsFamilies
Resources
www.iom.edu Institute of Medicinewww.ncpa.orgwww.aha.orgwww.hrsa.govwww.kff.org Kaiser Family Foundation
The System
“Dodging sick people is expensive business…”
Marcia Angell, MD Harvard Medical School for ANA News 4/7/2003