I.Forms of Health Care in the USA

1. Private
2. Medicare
3. Medicaid
4. C.C.S.
5. HMOs
6. No coverage

II.

1. The USA is the only industrialized nation without universal health care.
2. 45 million uninsured-especially women and children
3. By 2007-health care costs will be $200,000,000,000
   1. twice per patient of any other countr
   2. 16% of GNP
   3. infant mortality 8/1000
      (same as Greece or Czechoslovakia)

III.HMOs = managed health care = health maintenance organizations
…DEFICITS

1. Run by businessmen for profit
2. Less care = more profit
3. Negotiation of fees
4. Capitation
5. MDs rewarded for less care
6. Fire MDs for practicing good medicine
7. CEOs salaries (hundreds of millions)
8. MBAs practicing medicine without a license
9. Denial of optimal care
10. Cost-cutting
11. Destruction of endowments, teaching and research
12. Criminal activities

IV.Racism

1. H.I.V.
2. Chest pain
3. Cancer
4. Transplants
5. Prenatal care
   White-6/100,000 maternal deaths
   Latina-10/100,000
   Black-25/100,000
   

V.Medications

1. Drug companies
   
   1. 17% profit
   2. Prices have increased 4 X rate of inflation
2. USA could save $16,200,000,000 if drugs bought at same price as Canada
3. Eli Lilly Hoechst Price-fixing
   Abbott Restraint of trade
   …American Home Products
   …Noll

VI.DRGs = diagnosis-related-groups
Listing of categories including:

1. Reasons for hospitalization
2. Use of hospital services
3. Length of stay
4. Age
5. Discharge destination such as home, rehabilitation
   Each year the Federal Health Care Financing Administration determines Medicare reimbursement according to DRGs.

VII.Possible solutions:

1. Single-payer-Canada
   USA-$1,000/pt/yr.
   Canada-$250/pt/yr.
   US would save $100,000,000,000/yr.
   
2. Overhead
   HMOs-15%
   Canada-2.5% (same as Medicare)
3. Integrated Personal Medical Fund