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1. "MCS faced with double digit increases every yr in health care cost increases" and "The premiums in total for health care cost has really doubled over the past 10 years"
   -From MCS Files – Employee share in 2004 was $75.66 for Aetna in 2014 it is now $413.01 for Highmark Bluish Shield. In 2004 the monthly premium for Aetna was $710 and is now $one,529.66 for Highmark Blue Shield as of 2014.
2. "A Worker making minimum wage for an entire year is non making enough to pay for a wellness care benefit"
   "10 Dollars an hour for every hour they work"
   -Health insurance equals $18K cost for medical insurance is $ix per hour --- 2,000/18K = $9 *
3. "For an average family unit of 4 this years number is $23,000 dollars that's what a typical family unit insured that way costs" -(http://world wide web.milliman.com/uploadedFiles/insight/Periodicals/mmi/2015-MMI.pdf)
   In 2015 the average annual family insurance cost is $24,671
4. "Insurance companies are able to older employees up to 3x equally much as they would a younger employee"
   - The HHS report provides some details for premiums by age group, showing that a typical lx-twelvemonth-one-time individual will pay almost lx percent more than than a typical 27-year-old for the 2nd-lowest price silver plan. But, again, these figures don't include out of pocket expenses.
   http://world wide web.washingtonpost.com/blogs/she-the-people/wp/2014/06/24/older-women-comport-the-brunt-of-higher-insurance-costs-nether-obamacare/The costs of claims likewise increase with the age of the insured, as shown in Figure 2. The average costs of claims rise every 10 years for men from age 45 on and for women from age 35 https://www.bc.edu/content/dam/files/research_sites/agingandwork/pdf/publications/IB08_HealthInsurance.pdf
5. "Of 1 million bankruptcies in the U.South over sixty percent are because of medical related issues, and the bulk amount of those people have health insurance"-In 2013 1.7 Americans lived in households experiencing bankruptcies due to health intendance. 64 million Americans struggled to pay medical bills in 2014 - commonwealth fund of those 64 million Americans 59 percent were insured for the entire year - 36 per centum or 66 million Americans reported delayed care due to costs http://www.commonwealthfund.org/publications/Upshot-Briefs/2015/Jan/Biennial-Health-Insurance-Survey
   A study past the American periodical of medicine in 2007 62.ane percent of all bankruptcies have medical crusade. Near medical debtors are well educated and middle class citizens and ¾ of them had wellness insurance.
   The share of bankruptcies attributable to medical bug rose by 50 per centum between 2001 and 2007
   http://world wide web.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf
6. 1,973 American households file for bankruptcy every 24-hour interval - - 62% of bankruptices are medical related. There are i.2 million total bankruptcies a year. Debt.org
   - in 2005 1 out of 55 households filed for bankruptcies – Debt.org
   - Businesses are three per centum of bankruptcies – Debt.org
   - in 2011 ane,400,000 bankruptcies
   - in 2005 medical bills were 46% of bankruptcies – debt.org
   - in 2014 937k defalcation fillings and less than 3% were from businesses – U.S Bankruptcy Court- "Business organization and Non Business organization Cases Commenced Case Load Stats U.S Defalcation"
7. Richard chat about Premium Shares, and how an employee could end up paying an additional half dozen,000+ if one or two family unit members got sick.
   - Additional information from Kasier Employer Health Benefit Survey for data on Premiums
   - In 2014 the average contributions for employees are $one,081 for unmarried and $4,823 for family.
   - Family contribution has increased 81% since 2004
   - PPO is the most common health plan 54% of insured people had information technology in 2014
   - In 2009 the average deductible was $829 in 2014 it was $one,217
   - 73% of workers have co-pays for primary care physicians and 72% for specialty care
   - Average co-pay for in-network is $24 for chief and $36 for specialty
   - Average Coinsurance = 18% for master and 19% for specialty
   - 62% of covered works are in drug prescription plans with three or more tiers
   - 15% of plans pay fill cost of prescriptions once the deductible is met
   - 17% are in plans with the same cost sharing for all prescription drugs.
   - The Typical American family is not prepared for a major financial shock) simply has 21 days of income readily attainable – CNN Financial report * (we both have this on file) from the same report *Middle Course income families make between $36-60K the lowest income households earn less than $20,300. 60% of Americans take the same amount of wealth as they did in 1989. From the PEW Research centre 46 percent of Americans are considered Middle Form (http://www.pewresearch.org/fact-tank/2014/12/17/wealth-gap-upper-middle-income/#comments)
8. "health intendance costs are going up two percent above the aggrandizement rate and 2 to 2 ½ percent the projected growth of the Gross domestic product"
   Inflation - http://www.forbes.com/sites/castlight/2015/01/08/behind-the-numbers-are-healthcare-costs-really-getting-amend/
   Healthcare cost growth refers to the rate at which the national spending is increasing. In 2013, this was 3.half dozen per centum. That's the lowest rate of increment since 1960 when the government started keeping track of these things – simply it's still more than than double the 1.5 percent rate of inflation that nosotros saw in the broader Us economy in 2013.
   GDP - The U.S. Commerce Department's Bureau of Economical Analysis in its advance estimate (PDF) for 2nd-quarter gross domestic product showed healthcare spending climbed 4.nine% compared to the second quarter a year agone. The overall economy grew at a two.3% rate in the quarter.
   Information is from this article: http://world wide web.modernhealthcare.com/commodity/20150730/NEWS/150739985
   Which uses this information http://www.bea.gov/newsreleases/national/gdp/2015/pdf/gdp2q15_adv.pdf
9. Additionally from the CMS
   - https://www.cms.gov/research-statistics-information-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/downloads/proj2012.pdf
   - Wellness spending is projected to exist nineteen.9 percent of Gross domestic product past 2022.
   - Health spending is projected to grow at an average rate of 5.8 percent from 2012-2022, ane.0 percentage betoken faster than expected average annual growth in the Gross DomesticProduct (GDP).
10. "Health costs have gone up to three trillion dollars"
    NHE grew iii.half dozen% to $2.9 trillion in 2013, or $9,255 per person, and deemed for 17.iv% of Gross domestic product (GDP). https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet.html
11. We've gone from seven percent of the economic system dorsum in 1971 being health care to 18 percentage today" And "When the rest of the earth is spending less than 10 percent of their economies and getting health care to all of their citizens" http://www.commonwealthfund.org/publications/in-brief/2014/jun/global-slowdown-in-health-care-spending-growthS is currently 17.half dozen percent of the Gdp, compared to an boilerplate of 9.2% of the OECD countries
    Spending per person in the U.South is $viii,745 compared to an average of $three,355 for OECD countries
12. Chuck, Philadelphia school word
    http://6abc.com/archive/9130566/
    change teachers to school staff - June seven, 2013 -- The Philadelphia School District announced Friday is information technology laying off 3,783 people across entire range of district employees, from senior administrators to support staff.Class Size growth - School officials previously said they might have to lay off 1,300 employees, swell class sizes to xl or more, ax schoolhouse constabulary officers, and further cut services to students.At least one of those doomsday scenarios would not come to laissez passer, the superintendent said Wed."I'g saying definitively, I'm not going to put 40 children in a class," he told reporters, "because they're not going to be safe."
13. "If an ICU stay costs 30K a day, nosotros are shelling out 30K a solar day, that's half a law officeholder a day"
    - ICU - Mean intensive intendance unit cost and length of stay were 31,574 +/- 42,570 dollars and fourteen.4 days +/- 15.eight for patients requiring mechanical ventilation and 12,931 +/- 20,569 dollars and 8.5 days +/- ten.v for those non requiring mechanical ventilation http://www.ncbi.nlm.nih.gov/pubmed/15942342
14. Fall of the Blues source http://consumersunion.org/wp-content/uploads/2013/03/yourhealthdollar.org_blue-cantankerous-history-compilation.pdf
15. "The U.S has one of the shortest lengths of stays in hospitals per country" http://www.oecd-ilibrary.org/docserver/download/8111101ec033.pdf?expires=1441290089&id=id&accname=invitee&checksum=3D103CEAC83C04E955EDAB1DC02D9C0D
16. "Nosotros go to the physician near 4.2 times a year the Japanese get thirteen times" http://www.oecd-ilibrary.org/sites/health_glance-2011-en/04/01/g4-01-01.html?itemId=/content/chapter/health_glance-2011-29-en&_csp_=785dba4abcba409e00e41ac61cf308b1
17. Nurse word virtually billing and complexity file:///C:/Users/HP%20ENVY%2015/Downloads/FinalPaperworkReport.pdf
18. U.s.a. physicians spend 84k a yr just to interact with the private health insurance manufacture
    http://content.healthaffairs.org/content/30/8/1443.full?keytype=ref&siteid=healthaff&ijkey=mQS3t4CreN%2F1Y
    - We estimated physician practices in Ontario spent $22,205 per physician per twelvemonth interacting with Canada'due south single-payer bureau—just 27 percent of the $82,975 per medico per twelvemonth spent in the United States. US nursing staff, including medical assistants, spent twenty.6 hours per physician per week interacting with health plans—about 10 times that of their Ontario counterparts. If Usa physicians had administrative costs similar to those of Ontario physicians, the total savings would be approximately $27.6 billion per year.
19. Taiwan's spends i.5-1.half dozen% of its full budget on administration http://www.brookings.edu/inquiry/opinions/2015/05/xiv-taiwan-national-healthcare-cheng
    I'chiliad getting 1.vii here "Another critically important gene is the NHIA's powerful information engineering science (It)-driven authoritative system, which provides high administrative efficiency at depression cost. In 2014 the administrative budget for the NHI was 1.07 percentage of total NHI expenditure" http://world wide web.commonwealthfund.org/publications/in-the-literature/2014/sep/hospital-administrative-costs
20. Rationing DiscussionData from the CDC Summary Health Statistics for the U.S Population: National Wellness Interview Survey, 2012
    - About 25.nine 1000000 persons (8%) delayed seeking medical intendance in the terminal year due to toll and 19.2 million (6%) did not receive needed care due to the toll of intendance
    - Adults aged 18-44 and 45-64 were more likely than older adults and not children to filibuster seeking or not receive medical care due to cost.
    - Persons in the everyman income grouping were about x times every bit probable equally person in the highest income group to not receive needed medical intendance due to cost and more than 6 times every bit likely to delay seeking medical intendance.
    - Persons nether age 65 who were uninsured were almost 3x equally likely every bit persons who had Medicaid and other insurance to filibuster seeking or non receive needed medical care due to cost.
    - Persons who were in fair or poor health were near iii or four times as likely every bit persons who were in splendid or very good health to delay seeking or not receive needed medical intendance due to cost
    - Among persons under age 65, those with Medicaid (nine%) were more than probable than those who had private insurance (iv%) and those who were uninsured (4%) to have stayed overnight in the infirmary in one case in the by twelvemonth.
21. "84,000 lives could be saved yearly if the U.Due south lowered its preventable expiry charge per unit"
    http://www.commonwealthfund.org/~/media/images/publications/in-the-literature/2011/sep/preventable-death-l.gif
22. Berwick waste product report "Eliminating Waste matter in U.S Healthcare"
    http://jama.jamanetwork.com/article.aspx?articleid=1148376
23. Healthcare waste- Dartmouth 30% Excess Medicare spending According to the Dartmouth Establish for Health Policy and Clinical Practice, thirty percent of all Medicare clinical care spending is unnecessary or harmful and could be avoided without worsening health outcomes.
    http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_82.pdf
    $690 billion Waste in health care A September 2012 Constitute of Medicine report estimated that $690 billion was wasted in U.s.a. health care annually, not including fraud.
    The Plant of Medicine breaks those numbers downwardly, they also take u.s.a. at a $765 billion total in waste
    http://resources.iom.edu/widgets/vsrt/healthcare-waste.html
    another source
    http://economix.blogs.nytimes.com/2013/09/13/waste-vs-value-in-american-wellness-care/?_r=0
24. "MRI's cost $12,000 when in fact it could really cost them $300 to provide"
    - Charges for a unmarried MRI scan vary widely across the land for reasons beyond startup costs. According to the recently released Medicare data, MRIs charges are every bit little as $474 or as loftier as $13,259, depending on where you go. (Some other recent report of medical claims by Modify Healthcare constitute that in-network prices for certain MRIs tin can run from $511 to $2,815.) http://time.com/money/2995166/why-does-mri-cost-and so-much/ Article as well notes the national average is $ii,600
25. Hospital prices and variation http://www.huffingtonpost.com/2013/05/08/hospital-prices-price-differences_n_3232678.html

Provider Savings footnotes:

For provider savings we added all providers together and looked at the Himmelstein written report which showed that 26 percent of total expenditures was wasted in excess administration, which is the highest In comparison to other countries hospitals.

1. U.S. far out in front over again - in infirmary authoritative wasteA Comparing Of Hospital Authoritative Costs In Eight Nations: U.s.a. Costs Exceed All Others By Far. Past David U. Himmelstein, Miraya Jun, Reinhard Busse, Karine Chevreul, Alexander Geissler, Patrick Jeurissen, Sarah Thomson, Marie-Amelie Vinet and Steffie Woolhandler.
   Health Affairs, September 2014 http://www.pnhp.org/news/2014/september/us-far-out-in-front-again-in-hospital-administrative-wasteAnalysis of hospital authoritative costs across eight nations: Canada, England, Scotland, Wales, France, Germany, kingdom of the netherlands, and the United States. We found that administrative costs accounted for 25.3 percent of total US infirmary expenditures—a percent that is increasing. Next highest were the Netherlands (19.8 pct) and England (15.5 percent), both of which are transitioning to market-oriented payment systems. Scotland and Canada, whose unmarried-payer systems pay hospitals global operating budgets, with separate grants for capital, had the lowest authoritative costs. Costs were intermediate in France and Germany (which neb per patient simply pay separately for capital projects) and in Wales. Reducing The states per capita spending for hospital administration to Scottish or Canadian levels would have saved more than than $150 billion in 2011.

   Bureaucracy consumes one-quarter of US hospitals' budgets, twice as much as in other nations: Health Affairs study http://www.pnhp.org/news/2014/september/hierarchy-consumes-one-quarter-of-us-hospitals%E2%80%99-budgets-twice-as-much-as-in-ot

   A study of hospital authoritative costs in viii nations published today in the September outcome of Wellness Affairs finds that infirmary bureaucracy consumed 25.3 percentage of hospital budgets in the U.Due south. in 2011, far more in other nations.

   Hospital authoritative spending totaled $667 per capita in the U.S., vs. $158 in Canada, $164 in Scotland, $211 in Wales, $225 in England and $325 in holland.

   Administrative costs were lowest (well-nigh 12 percent) in Scotland and Canada, whose single-payer systems fund hospitals through global, lump-sum budgets, much equally a fire department is funded in the U.Due south.

   The article attributes the high administrative costs in the U.S. to two factors: (1) the complication of billing a multiplicity of insurers with varying payment rates, rules and documentation requirements; and (2) the entrepreneurial imperative for hospitals to amass profits (or, for nonprofit hospitals, surpluses) in club to fund the modernization and upgrades essential to survival.

   "We're squandering $150 billion each twelvemonth on hospital bureaucracy," said atomic number 82 author Dr. David Himmelstein, a professor at the CUNY/Hunter Higher School of Public Health and lecturer at Harvard Medical School. "And $300 billion more is wasted each year on insurance companies' overhead and the paperwork they inflict on doctors."

   He added: "Only a single-payer reform tin clasp out the bureaucratic waste and use the coin to give patients the care they need. Instead, we're layering on more than bureaucracy in insurance exchanges and 'accountable intendance organizations"

   He added: "Only a unmarried-payer reform can squeeze out the bureaucratic waste matter and use the money to give patients the care they need. Instead, we're layering on more bureaucracy in insurance exchanges and 'accountable care organizations.'

   Dr. Steffie Woolhandler, senior author of the report, said: "For iii decades our policy makers have pushed market place-oriented strategies that accept turned health intendance into a business. As a consequence, Americans now have the world's costliest health intendance, and our life expectancy is years shorter than in most other wealthy nations. It'southward fourth dimension to admit that, when it comes to caring for sick people, markets don't work."

2. Physician Practices in the U.S. Spend Nearly $83,000 Annually Per Physician on Authoritative Costs, Nearly Four Times every bit Much every bit Canadian Practices Spend
   http://www.commonwealthfund.org/publications/printing-releases/2011/aug/medico-practices-and-administrative-costsPhysician practices in the U.Due south. spend significant amounts of time and labor interacting with multiple health plans on claims and billing, obtaining prior potency for patient services, and dealing with pharmaceutical formularies. The physician and staff fourth dimension spent on these interactions is estimated to cost at least $82,975 per md annually in the U.S., compared with $22,205 in Ontario, Canada, co-ordinate to a written report published in the July issue of Wellness Affairs. The study was partially supported past The Democracy FundThe amount spent on these activities by practices in the U.South was about four times that spent past their counterparts in Ontario interacting with Canada'south unmarried-payer system, according to estimates by lead writer Dante Morra of the Department of Medicine at the University of Toronto and colleagues, based on surveys of physicians and administrators. If U.Due south. doctor practices had administrative costs similar to those in Ontario, the full savings for U.Due south. health spending would be about $27.half-dozen billion per year.

   The authors notation that per capita health spending in the U.Southward. is 87 percent higher than in Canada—$7,290 vs. $iii,895 annually—saying that "many factors contribute to the high cost of health care in the United States, simply there is broad consensus that authoritative costs are high and could be reduced

   Additional findings from the study, "U.South. Physician Practices Spend Nearly 4 Times equally Much Money Interacting with Health Plans and Payers than Do Their Canadian Counterparts":

   U.Due south. physicians spend 3.iv hours per week interacting with health plans, significantly more than the 2.2 hours per week Ontario physicians spend interacting with the Canadian unmarried payer plan. About of the difference comes from one hr per week that U.S. physicians spend obtaining prior authorizations.

   Nurses and medical administration spend 20.vi hours per physician per week on administrative tasks related to health plans, nigh 10 times the time spent by Canadian practices. More than than 13 of these hours per week are spent obtaining prior authorization for medical services that physicians believe are needed by patients.

   U.South. clerical staff spend 53.ane hours per physician per week on administrative tasks related to insurance, compared to 15.9 hours in Ontario. Near of the difference comes from the fourth dimension U.S. clerical staff spend on billing (45.five hours) and obtaining prior authorizations (vi.3 hours)

   Senior administrators of medico practices in the U.S. spend much more fourth dimension per physician than their Canadian counterparts on overseeing claims and billing tasks: 163.2 hours a yr in the U.Southward. compared to 24.6 hours a twelvemonth in Ontario.

   Physician practices spent very little fourth dimension submitting quality data to wellness plans in either the U.s. or Ontario.

Pharmacy footnotes:

1. From Bloomberg business: http://world wide web.bloomberg.com/news/articles/2015-04-14/u-s-drug-spending-increases-near-in-13-years-to-373-9-billion"U.S Drug Spending Increases most in xiii years to 373.9 Billion""Last year'due south $43 billion growth in spending on medicines was the highest e'er," said Murray Aitken, executive director the IMS Institute for Healthcare Computer science, which issued the study. The institute is part of IMS Health Holdings Inc., a data company that tracks prescription drug use.

   Much of the increment came from treatments for hepatitis C, cancer, diabetes and multiple sclerosis afterwards U.Southward. regulators approved more than new drugs than any year since 2001. In total, spending on prescription drugs rose xiii.1 percent in 2014, co-ordinate to the study.

   11.7 one thousand thousand Americans gained wellness coverage nether the Patient Protection and Affordable Care Human action, they weren't a major driver of the spending growth, Aitken said. The main contributors were new and expensive specialty treatments, which include medicine for viral diseases, cancer and auto-immune disorders such as rheumatoid arthritis.

   Drugmakers introduced four new products for hepatitis C, a liver virus that's infected about 3 meg people in the U.South. The drugs are amongst the near expensive treatments ever, with Gilead Sciences Inc.'due south Harvoni listing at more than $1,000 a pill. In total, the U.S. spent $12.3 billion on the treatments, according to the report.

2. Prescription drug spending jumps 13% to tape $374 billion in 2014From LA Times: http://www.latimes.com/business concern/la-fi-drug-costs-20150414-story.htmlThe influx of millions of people newly insured under the Affordable Intendance Deed was less of a gene than expected — most $1 billion of the spending growth, it said.

   The majority of that was from people seeking breakthrough treatments for hepatitis C — a cure that came with a wallop at the cash register. A 12-week treatment of Gilead Sciences Inc.'s breakthrough hepatitis C drug Sovaldi could cost more $80,000 per patient.

   Gilead's drugs Sovaldi and Harvoni drove near x times as many people to showtime treatment for hepatitis C last yr than in 2013, the report said. Sovaldi, in its commencement full year on the market, became the top-selling drug in the United States, the written report said.

3. Why do Americans spend so much on pharmaceuticals?
   http://world wide web.pbs.org/newshour/updates/americans-spend-much-pharmaceuticals/The United States spends almost $i,000 per person per yr on pharmaceuticals. That'due south around forty per centum more than the next highest spender, Canada, and more than than twice as much every bit than countries similar French republic and Deutschland spend.Prices in the U.S. for make-proper noun patented drugs are 50 to 60 pct higher than in France and twice as high as in the United kingdom of great britain and northern ireland or Australia.

4. http://www.huffingtonpost.com/2014/04/17/wellness-intendance-costs_n_5160819.html More Proof That American Health Intendance Prices Are Sky-High

• A prescription for Nexium, a popular remedy for acid reflux disease and other stomach ailments, costs $215 on average in the U.Due south., which is more than iii.5 times the cost in Switzerland, the 2d-most-expensive nation for Nexium prescriptions, and well-nigh 10 times more than what Dutch people pay.

5. Sales of Sovaldi, New Gilead Hepatitis C Drug, Soar to $x.iii Billion

• Gilead Sciences sold $10.3 billion of it'southward new hepatitis C drug Sovaldi in 2014.
• Its success with hepatitis C more than than doubled Gilead'southward overall revenues to $24.9 billion in 2014, compared to $xi.two billion a year earlier. Net income afterward certain adjustments was $13.3 billion, or $8.09 per diluted share, compared to $iii.5 billion, or $two.04 per diluted share for 2013.
• In the quaternary quarter lone, revenue was $seven.3 billion, compared to $iii.1 billion for the quaternary quarter of 2013. Net income, afterwards adjustments, was $3.nine billion, or $2.43 per diluted share, compared to $930 million, or 55 cents per diluted share, a yr earlier.
• In improver Gilead has stuck a deal with Indiana manufacturers to create a generic version of the pill which will cut the drugs price by 99% for poor countries. For example in the U.Due south Sovaldi costs i,000 a pill or $84,000 for the recommended 12 week treatment, in India it is likely to be sold for less than $ane,800 for a 24 week treatment. Gilead plans to innovate the drug in Bharat for about $10 a pill. 1 percent of the price in the U.Southward - http://www.nytimes.com/2014/09/16/business/international/maker-of-hepatitis-c-drug-strikes-bargain-on-generics-for-poor-countries.html

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