FIXING WHAT AILS HEALTH CARE IN AMERICA TODAY

PATIENTS OVER POLITICS

INCREASING NUMBER OF AMERICANS UNINSUREDINCREASING NUMBER OF AMERICANS UNINSURED

54 million people

47 million people

• Over 50 million people are uninsured

• An additional 72 million people have inadequate insurance

• Only 71%of small businesses with 10-24 workers and 48% of businesses with fewer than 10 workers offer coverage

WHAT PREVENTS PEOPLE FROM

GETTING ADEQUATE INSURANCE?

WHAT PREVENTS PEOPLE FROM

GETTING ADEQUATE INSURANCE?

THE SKYROCKETING COST OF HEALTH CARE

THE SKYROCKETING COST OF HEALTH CARE

The annual health care cost for an American family is

more than $20,728:That’s a new car!

Medical bills contribute to at least

62% of bankruptcies in the United States

30% OF HEALTH CARE COSTS ARE WASTED

30% OF HEALTH CARE COSTS ARE WASTED

Totaling over $600 billion$600 billion

More and more people can’t afford to see a doctor

EVEN IF YOU COULD AFFORD INSURANCE . . .

EVEN IF YOU COULD AFFORD INSURANCE . . .

Your children could only stay on your insurance until age 19 or until they finished school – whichever came first

Lifetime spending limits: once you became too expensive, insurance companies could stop paying for treatment

Insurance companies could drop coverage once you became sick

DIABETESASTHMA

HEART MURMURHEARTBURN

WAS ONCE PREGNANT

ALLERGIC TO PEANUTS

BACK PAIN

DEPRESSION

HIGH BLOOD PRESSURE

PRE-EXISTING =CONDITIONS

BIRTH DEFECT

The Wheel of Burden

HOW DO WE ENSURE ACCESS TO HIGH

QUALITY AND AFFORDABLE

HEALTH CARE?

HOW DO WE ENSURE ACCESS TO HIGH

QUALITY AND AFFORDABLE

HEALTH CARE?

Introducing:

THE ACA FOCUSES ON 3 KEY CHALLENGES

THE ACA FOCUSES ON 3 KEY CHALLENGES

32 million Americans will be insured

under the Affordable Care Act!

32 million Americans will be insured

under the Affordable Care Act!

HOW DO WE GET PEOPLE COVERED?

HOW DO WE GET PEOPLE COVERED?

Medicaid expansion

Tax credits for small businesses

Subsidies to buy into the exchange

Allowing over 5 million young adults to stay on their parents’ plan

HEALTH INSURANCE EXCHANGES

HEALTH INSURANCE EXCHANGES

• Creates a marketplace to compare health plans

• Open to everyone – required for members of Congress

• Standardizes a minimum benefits package to eliminate flimsy plans

• Increases transparency and negotiating ability

Begins on January 1st, 2014

= supermarkets for health insurance

INDIVIDUAL MANDATEINDIVIDUAL MANDATE

• If you have health insurance you are good to go

• If you cannot afford it, you will qualify for subsidies to purchase it in the exchange

• If you can afford it and still choose not to get it, you will pay a fine

NEW CONSUMER PROTECTIONSNEW CONSUMER PROTECTIONSProtect people from unfair insurance practicesProtect people from unfair insurance practices

Full implementation by 2014

No more lifetime limits on coverage

No “pre-existing condition” discrimination

80+% of premiums must be spent on care– or you get $$

back

No more discrimination

against womenby charging higher

rates

Starts January 1st, 2014

NEW CONSUMER PROTECTIONSNEW CONSUMER PROTECTIONSProtect people from unfair insurance practicesProtect people from unfair insurance practices

PREVENTION AND WELLNESSPREVENTION AND WELLNESSInvest in Prevention and Healthy Choices

*National Prevention Council will create a National Prevention Strategy.

*National Prevention Council will create a National Prevention Strategy.

Starts January 1st, 2014

THE ACA IS GOOD FOR DOCTORS

THE ACA IS GOOD FOR DOCTORS

Better care for

your patients

Better care for

your patients

Incentives for medical students to choose

PRIMARY CARE

Incentives for medical students to choose

PRIMARY CARE

WORKFORCE STRENGTHINGWORKFORCE STRENGTHING

Educational incentives established for:

– Doctors– Nurses– Other health care

professionals– Focus on Primary Care– MORE NEEDED!

Educational incentives established for:

– Doctors– Nurses– Other health care

professionals– Focus on Primary Care– MORE NEEDED!

GETTING MORE VALUE FOR OUR MONEY

GETTING MORE VALUE FOR OUR MONEY

Programs and incentives are put in place for doctors and hospitals to:

– Communicate better– Decrease

complications– Study what treatments

work best– Help patients stay

healthy/get well

Programs and incentives are put in place for doctors and hospitals to:

– Communicate better– Decrease

complications– Study what treatments

work best– Help patients stay

healthy/get well

REAL STORIES, REAL PEOPLEREAL STORIES, REAL PEOPLE

Baby Jax• He and his twin brother were

born in August of 2011• Jax was born with a genetic

disorder and a serious heart condition

• He underwent open heart surgery at only 2 months old

• His first day in the Neonatal Intensive Care Unit cost $150,000 – he stayed for 21 days

Baby Jax• He and his twin brother were

born in August of 2011• Jax was born with a genetic

disorder and a serious heart condition

• He underwent open heart surgery at only 2 months old

• His first day in the Neonatal Intensive Care Unit cost $150,000 – he stayed for 21 days

REAL STORIES, REAL PEOPLEREAL STORIES, REAL PEOPLEBaby Jax

• Thanks to the ACA, Jax’s family doesn’t have to worry about his “pre-existing” conditions

• They also don’t have to worry about reaching a lifetime cap on coverage – which he would have in his first year of life

• Jax’s family will be able to keep their house, pay their bills, and afford to care for all three of their children.

• Jax can live a healthy life and pursue his dreams.

Baby Jax• Thanks to the ACA, Jax’s family

doesn’t have to worry about his “pre-existing” conditions

• They also don’t have to worry about reaching a lifetime cap on coverage – which he would have in his first year of life

• Jax’s family will be able to keep their house, pay their bills, and afford to care for all three of their children.

• Jax can live a healthy life and pursue his dreams.

The ACA and the US

• 3.1M more young adults are now covered under their parents’ plan

• 5.2M Medicare beneficiaries received $3.9M in drug rebates to close the ‘donut hole’

• 54M more Americans received free preventative services

• 12.8M Americans have qualified for a $1.1B rebate from insurance companies

THE ACA IS AT RISKTHE ACA IS AT RISK

• Politicians are endangering your health for political gain, calling for repeal

• If the ACA is compromised…

32 million Americans will lose their

insurance

32 million Americans will lose their

insurance

Jax could lose his insurance based on

his pre-existing condition and lifetime

spending limit.

THE ACA IS AT RISKTHE ACA IS AT RISK

A 23 year old graduate looking for a job will no longer be insured through her parents

THE ACA IS AT RISKTHE ACA IS AT RISK

A 60 year old grandmother with breast cancer will reach her lifetime

insurance limit and be denied life saving treatment

Families will continue to struggle with medical bills

WHAT CAN YOU DO?WHAT CAN YOU DO?• Contact your elected officials,

asking them to protect the ACA

• Tell a friend what you learned

today

• Invite one of our members to give

a presentation

• Learn about healthy choices for everyday life

• Continue to be informed about your health care

• Take advantage of preventive care offered through the ACA

www.drsforamerica.orgwww.drsforamerica.org

THANK YOU!