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The American Hispanic Coalition Proposes Universal Health Care for All Persons Living in the USA
PHOENIX (By Jon Garrido, Hispanic News) June 24, 2004 - The American Hispanic Coalition released its report today stating the United States health care system was in crisis and universal health coverage provided by the Federal Government is the solution. The health care delivery system is incapable of meeting the present, let alone the future, needs of all Americans. The cost of private health insurance is increasing at an annual rate in excess of 12 percent. Individuals are paying more out of pocket and receiving fewer benefits. One in seven Americans is uninsured, and the number of uninsured is on the rise. States, suffering severe fiscal problems, are cutting eligibility and benefits in Medicaid and other health programs that have an adverse impact on all Americans particularly Hispanics. Health care is not a top priority in Washington at the moment, as officials worry about the economy, terrorism and the aftermath of the war in Iraq. The American Hispanic Coalition will advocate health care reform move to the top of the nation's agenda in the 2004 presidential election. The American Hispanic Coalition Report's Recommendations:
Propelled by Drug and Hospital Costs, Health Spending Surged in 2002 National health spending shot up 7.3 percent to $1.8 trillion in 2002, with Hospital and drug costs as the main factors in the increase. The report also cited more spending on Medicare and resistance to the constraints of managed care. Health costs and spending are likely to climb faster even though the economy has been weak. As a result, the report states, consumers will have to spend more of their own money on health care, and employers may be less inclined to offer health insurance to workers because health benefits have become more expensive. Increased job layoffs in the slowing economy will lead to a less competitive job market, reducing private employers' incentive to shoulder rising health care costs, potentially increasing the number of uninsured persons according to the report published today by the American Hispanic Coalition. "Competition may force employers to shift a larger share of rising costs to workers, who may no longer be able to afford accelerating out-of- pocket costs. Fewer employers may offer health insurance, and the recently unemployed are often left without coverage." "The new national health spending estimates may well mark the end of an era of reasonably affordable health care cost growth." The surge in health costs puts pressure on politicians to respond, but also makes them anxious about the cost of expanding public programs or offering large new subsidies for the purchase of insurance. The nation spent an average of $4,637 on health care for each person in the United States in 2000, up from $4,377 in 1999, $4,001 in 1997 and $2,966 in 1991. These numbers were not adjusted for inflation. Predicted is a stronger increase in the health spending share of gross domestic product in the near future. Health care employment, prices and premiums all increased last year. The report identifies two main reasons for the surge in health spending: resistance to managed care by doctors, hospitals and consumers, and a decision by Congress to restore money cut from Medicare, the federal program for the elderly and disabled, which accounts for 17 percent of all health spending. National health spending rose $83.9 billion in 2000, and hospital care and prescription drugs accounted for 45 percent of the increase. Spending on hospital care rose by $19.9 billion, or 5.1 percent, to $412.1 billion, while drug spending grew $17.9 billion, or 17.3 percent, to $121.8 billion. The figures for hospitals were significant because hospital spending had not risen more than 4 percent in any year since 1993. Outpatient hospital revenue is growing twice as fast as inpatient revenue. Hospitals say they need the money to cover rising labor costs. Weekly wages paid to workers in private hospitals rose 4.1 percent in 2000; in 1999, the figure was 2.3 percent, the report said. Prescription Drugs are still the fastest growing category of health spending. Drug spending increased 19.2 percent in 1999, 17.3 percent in 2000, 21.3 percent in 2001, and 23.1 percent in 2002, the eighth consecutive year of double digit growth. Total national spending on prescription drugs doubled in the five years from 1995 to 2000 and tripled in the decade from 1990 to 2000, according to government data. The report cites several reasons for the rapid increase, including the effects of prescription drug advertising, wider availability of insurance to cover drug costs, an increase in the number of prescriptions written by doctors and a shift toward greater use of new, higher-price drugs. Hospitals accounted for 31.7 percent of all health spending in 2000, down from 42 percent in 1982. By contrast, prescription drugs accounted for 9.4 percent of the total in 2000, double their share in 1982. The report also said private health insurance premiums increased 8.4 percent in 2000, to a total of $444 billion, after rising less than 7 percent a year from 1996 to 1999. It is estimated $500 billion is the amount of 2004 premiums. The Uninsured The widely used estimate that 41 million Americans lack health insurance year-round may be double the real figure, the Congressional Budget Office says, an estimate that could roil the debate over reshaping the nation's health care system. The nonpartisan budget office issued a study estimating that 21 million to 31 million people are without coverage all year. Overall, at least 59 million are uninsured at least briefly in a given year, the report said. The Budget Office report could fuel the arguments of both political parties as they prepare to tackle the issue in Congress and on the 2004 campaign trail. Republicans, who generally favor less costly approaches, could cite the budget office's conclusion that there are fewer people without coverage all year than the 41.2 million estimated by the Census Bureau. Democrats could use the 59 million estimate for Americans who lack insurance for at least some period to argue that the need is even more widespread. "There are two problems, short spells and long-term un-insurance,'' Douglas Holtz-Eakin, the agency's director, said in an interview. "There is no such thing as the typical uninsured.'' Though there is no doubt that extending coverage to more people would be hugely expensive, defining the problem's magnitude is significant because it will affect which policies lawmakers might design to address it. The budget office said nearly half the 59 million uninsured in a given year are without insurance for less than four months. An additional 30 percent are uncovered for more than a year, the report estimated. The biggest demographic group likeliest to face long periods without health care coverage are Hispanics, the report said. The analysis by the budget office was based on data from the Census Bureau and other federal sources for 1998, which the report said is the most recent year for which there is reliable data. A Squeeze on Employers There's tremendous pressure in the business community and among employers and employees to address health care reform including the National Federation of Independent Business and the U.S. Chamber of Commerce pushing for action because of complaints about snowballing costs. Political pressure is coming not only from workers who lack health insurance but also from employers squeezed by the costs of providing it. Big companies say escalating health care costs are hurting their ability to compete around the world. Small businesses say coverage has become increasingly expensive and unreliable. An employer survey found companies' cost of providing health benefits for workers rose 15% this year and is expected to rise by a similar amount next year, the biggest back-to-back percentage gains since 1989 to 1990. The increases are driven by expensive new technologies, the growing medical demands of a graying population and a backlash against the managed-care limits that brought savings. Health Insurance Costs Fire Up Unions Rapidly rising health care costs are causing strife at bargaining tables nationwide as employers seek to shift some of the burden to workers while unions battle to save benefits. This year's labor negotiations come as health insurance costs are rising at their fastest clip in a decade. Managed care is no longer slowing medical inflation, so employers are searching for new solutions, but there are few proposals that provide a short-term, quick fix. Our benefits are among the best in the industries we are in," says GE spokesman Gary Sheffer. "We are simply asking employees to share a modest portion of the double-digit increases we've seen in health care. But unions see the shift of costs to workers as an attack on what has long been a perk of union membership: access to high-quality, low-cost health insurance. Health care costs are going up: an estimated 15% rise in premiums on average for 2004. Overall spending on health care services hit $1.4 trillion nationally in 2001, rising at the fastest rate since 1991, according to federal statistics. Health care spending now accounts for 14.1% of the nation's gross domestic product. And employers are wrestling with what to do. While out-of-pocket costs for workers are still lower than they were a decade ago, before managed care slowed their increase, most insured workers are being required to spend more on their coverage this year. A recent Towers Perrin survey of 358 employers found that workers will pay 19.3% of health insurance premiums this year, up from 18.7% in 2002. That same survey found that 75% of firms had increased deductibles, co-payments or monthly contributions paid by workers in the past two years. "Annual increases in health care costs are growing at historically high levels that show no sign of abating," the Perrin report says. For some, the fight over health care is not simply to keep employee costs down but to get coverage in the first place. In late 2002, janitors in Boston won public support during a month-long strike and succeeded in winning health insurance benefits for about 1,000 part-time contract janitors, mainly by putting pressure on building owners to ante up the cost. "For low-wage workers, having to pay part of the premium causes them to opt out," says Stephen Lerner, who runs the "Justice for Janitors" campaign for the Service Employees union. "If you're making $9 or $10 an hour and someone says you have to pay $100 a month for insurance, they end up not having insurance," Lerner says. Individuals President Bush has proposed spending $89 billion over the next decade for a tax credit that would subsidize up to 90 percent of the costs of health insurance for low- and middle-income people. The American Hispanic Coalition notes when Hispanics are in need of medical services and are unable to pay for such services, there is very little comfort knowing the following year a refundable tax credit for uninsured people will provide assistance to those who can't afford even reduced premiums. The Veterans Administration Program The VA operates the largest integrated healthcare system in the United States, making it an essential asset in responding to providing health care to all Americans. Along with 163 major health centers including major hospital facilities, the VA has more than 800 outpatient clinics staffed by over 200,000 health care professionals. The annual 2004 budget is $56.9 Billion serving more than 6.8 million veteran users. Using the model of approximately $10 Billion to serve 1 million users, $500 Billion would be needed to serve 50 million users. Additional outlays would be required to provide facilities primarily in the form of satellite clinics such as the VA currently operates in urban and rural areas. Prescription Drug Patents
Presently, nearly 72% of all drug research in the United States is funded by American taxpayers through funding of the National Institutes of Health.
President Bush doubled NIH funding providing for a 15% or $3.4 billion increase and a total FY 2002 budget of $23.4 billion. The American Hispanic Coalition proposes FY 2004 funding be increased to $50 billion essentially allowing for funding of all pharmaceutical research with the requirement all discoveries by pharmaceutical and institutional grant recipients funded by the NIH stay in the public domain. With the elimination of drug patents for publicly funded discoveries, all drug discoveries would be available to generic drug manufacturers to enter the competitive prescription drug market place and thereby dramatically reduce the cost of prescription drugs for all Americans. No longer will pharmaceutical companies be able to support arguments monopolies enabling high prices are required to offset a $500 million research cost (never documented by any entity) per drug to bring its discovery to the prescription drug marketplace. All discoveries of pharmaceutical drugs approved by the FDA but funded entirely by private funds would honor all intellectual property rights and patents for a period of ten years with no extensions including those requested in the "Orange Book." The new approach to decreasing prescription drug prices will sharply reduce not only Medicare costs but will benefit every American requiring medication. For nearly three years from the beginning of The American Hispanic Coalition, the focus of The American Hispanic Coalition has been to eliminate drug patents funded by the US Government and make all drug discoveries available to generic drug manufacturers.
We were convinced only branded drug manufacturers were guilty of greed in extorting high costs for branded prescription drugs.
We were wrong.
Now that 20 year branded drugs monopolies are expiring and the use of generics are increasing, we are alarmed at the increasing cost of generic drugs becoming just as expensive as the branded drugs generics are replacing. With the elimination of drug patents for those drugs funded by the NIH, manufacturing of all drugs discovered by research funded by the US Government will be available to all drug manufacturers. Financing and Benefits of the American Hispanic Coalition Proposal
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