40% Favor Single-Payer Health Care System, 44% Oppose
Rasmussen Reports, December 17, 2012
Forty percent (40%) of Likely U.S. Voters favor a single-payer system, according to a new Rasmussen Reports national telephone survey. Forty-four percent (44%) oppose the creation of such a system. Sixteen percent (16%) are undecided.
The question asked:
Do you favor or oppose a single-payer health care system where the federal government provides coverage for everyone?
(Conducted December 10-11, 2012. Margin of Sampling Error, +/- 3 percentage points with a 95% level of confidence.)
Rasmussen telephone surveys are noted for results demonstrating right-wing bias. Understanding that, it is interesting that the results of this poll demonstrated a near even split in public support for single payer.
Several surveys from other sources have demonstrated closer to sixty percent support for single payer. Considering the likely bias in this poll, there does not seem to be any significant decline in support for single payer even though the Affordable Care Act is already being implemented.
As people observe how many will be left uninsured and how ineffective the plans will be in protecting personal finances, it can be anticipated that support for single payer will continue to grow until it reaches a threshold where it finally becomes a political imperative.
This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.
Statement on Healthcare
Econ4, December 2012
We are economists who think that the economy should serve people, the planet and the future.
We oppose treating health care as a commodity to be rationed on the basis of purchasing power or a privilege to be rationed on the basis of political power.
We call for a national health insurance system that provides universal access to essential health care.
We call for insurance for all Americans in a single risk pool – the efficient model already used by Medicare and the Veterans Administration – a system that can save billions of dollars while improving health and well-being.
We extend our support to all who are working to build an effective and accountable health care system that puts public health before private profit and secure health care for all regardless of income, age, or pre-existing conditions.
(Signed by over 100 economists)
Against a background of depressing news during this Holiday Season, this group of social-minded economists is sending us a message of hope for a better health care system for all of us.
The link above will lead you to a ten minute video featuring four of the over 100 economists that signed onto this message. It is a video that you likely will want to share with others.
This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.
Wayne Lapierre, CEO & Executive Vice President
NRA (National Rifle Association), December 21, 2012
The ONLY thing that stops a BAD guy with a gun is a GOOD guy with a gun.
(There is a not-so-subtle message here about the health of the nation.)
This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.
Next Challenge for the Health Law: Getting the Public to Buy In
By Abby Goodnough
The New York Times, December 19, 2012
On its face, the low-key discussion around a conference table in Miami last month did not appear to have national implications. Eight men and women, including a diner owner, a chef and a real estate agent, answered questions about why they had no health insurance and what might persuade them to buy it.
But this focus group, along with nine others held around the country in November, was an important tool for advocates coming up with a campaign to educate Americans about the new health care law.
The sessions confirmed a daunting reality: Many of those the law is supposed to help have no idea what it could do for them.
There lies the challenge for Enroll America, a nonprofit group formed last year to get the word out to the uninsured and encourage them get coverage, providing help along the way. With the election over and the law almost certain to survive, the group is honing its fund-raising and testing strategies for persuading people to sign up for health insurance — a process that will begin in less than a year.
The group has raised only about $6 million so far — but financial backers include some major players in the medical industry: insurers like Aetna and Blue Cross Blue Shield, associations representing both brand name and generic drug manufacturers, hospitals and the Catholic Health Association.
Over the next two years, the group hopes to raise as much as $100 million for advertising, social media and other outreach efforts. “There are so many different groups that can play some role in this: hospitals, community health centers, pharmacies, tax preparers,” said Ron Pollack, chairman of Enroll America’s board. “Our job has got to be to try to galvanize each of those sectors, so there is a wide variety of ways people potentially can hear about this.”
In addition to holding focus groups in Miami, Philadelphia, San Antonio and Columbus, Ohio, Enroll America commissioned a nationwide survey to help hone its message. The survey, conducted in September and October by Lake Research Partners, a Democratic polling group, found that the vast majority of uninsured people are unaware of the new coverage options provided by the law.
They are also skeptical. Many who participated in the focus groups or survey reported bad experiences trying to get health insurance, and doubted that the law would provide coverage that was both affordable and comprehensive.
“It’s two major mountains that need to be climbed,” Mr. Pollack said. “People are unaware of the benefits that could be provided to them, and they have to overcome skepticism, based on their past experiences with trying to obtain insurance.”
But the survey found that even with federal subsidies, many uninsured people may balk at the cost of coverage. Only about a third of respondents leaned toward thinking monthly premiums of $210 for a single person earning $30,000 a year, for example, were affordable.
Those amounts became more acceptable when respondents were told it would “protect you from thousands of dollars of medical debt if you got sick” or “cover all of the basic care you need.”
In the end, Lake Research Partners recommended that Enroll America not cite specific dollar amounts at all when they talk to the uninsured about new coverage options. “Talking about ‘free or low cost’ plans may be more motivating,” the survey authors wrote in a report.
From the days of the Clinton effort to reform health care, Ron Pollack of Families USA has opposed single payer reform as not being politically feasible, supporting instead reform based on private insurance plans. Likewise, Celinda Lake of Lake Research Partners has actively rejected single payer while using her polling and focus group activities to push the rhetoric of “Choice” to promote private insurers, glossing over the fact that private insurers take away choice of health care professionals and institutions. Both Pollack and Lake have had considerable influence in Democratic administrations.
Now that they got their wish and we have reform based on private insurance plans, they have a new hurdle and that is to try to sell the program to the public. They have formed a new organization, “Enroll America,” to do just that, and the private insurance industry is front and center in financing the organization.
Just as they concocted the “Choice” campaign to sell the legislation, they are now concocting the “Free or Low Cost” campaign to sell the uninsured on the new coverage options. When the survey found that many people may balk at the cost of coverage even with the subsidies, Lake recommended that Enroll America not cite specific dollar amounts at all when they talk to the uninsured about new coverage options.
Can you imagine? Just as they sold the nation on legislation using “Choice” for a program that takes away choice, they now are selling the nation on “Free or Low Cost” plans that the uninsured cannot afford to pay for. What chutzpah!
Where is the Occupy movement? Maybe we should occupy Enroll America and use it instead to enroll everyone in a single payer national health program – an Improved Medicare for All.
Cleveland Clinic Diagnoses Health-Care Act
By Anna Wilde Mathews
The Wall Street Journal, December 18, 2012
Just over a year from now, the Affordable Care Act is set to unleash enormous change in the health-care sector, and Cleveland Clinic Chief Executive Delos “Toby” Cosgrove is preparing his institution by expanding its reach and striving to make caregivers more cost-conscious.
WSJ: Do you think employers will stop providing health insurance, even though they can pay a penalty under the health overhaul law?
Dr. Cosgrove: The first ones will be the small companies… Every CEO I’ve talked to knows how much he’d save between insuring his people and paying the federal penalty.
WSJ: What does that tell you?
Dr. Cosgrove: The first time some big player does that, it’s going to fall like dominoes. What that does is drive everybody to the exchanges.
WSJ: What does that mean to you?
Dr. Cosgrove: It’s going to be a faster move towards one payer. Increasingly, people think that in 10 years you’re going to have 75% of the health-care costs paid by the federal government.
WSJ: You think we’re moving toward a single-payer system?
Dr. Cosgrove: Well, the question is how long…I don’t think in the next 10 years, but I think it probably is going to head in that direction.
Cleveland Clinic President and CEO Delos “Toby” Cosgrove confirms what Physicians for a National Health Program has been saying all along. It’s not whether we’ll ever have single payer, it’s how long.
It’s our job to expedite it.
Risk Adjustment Data Validation of Payments Made to PacifiCare of California for Calendar Year 2007
Department of Health and Human Services
Office of Inspector General, November 2012
Under the Medicare Advantage (MA) program, the Centers for Medicare & Medicaid Services(CMS) makes monthly capitated payments to MA organizations for beneficiaries enrolled in the organizations’ health care plans. Subsections 1853(a)(1)(C) and (a)(3) of the Social Security Act require that these payments be adjusted based on the health status of each beneficiary. CMS uses the Hierarchical Condition Category (HCC) model (the CMS model) to calculate these risk-adjusted payments.
The diagnoses that PacifiCare submitted to CMS for use in CMS’s risk score calculations did not always comply with Federal requirements. For 55 of the 100 beneficiaries in our sample, the risk scores calculated using the diagnoses that PacifiCare submitted were valid. The risk scores for the remaining 45 beneficiaries were invalid because the diagnoses were not supported by the documentation that PacifiCare provided.
As a result of these unsupported diagnoses, PacifiCare received $224,388 in overpayments from CMS. Based on our sample results, we estimated that PacifiCare was overpaid approximately $423,709,068 in CY 2007. The confidence interval for this estimate has a lower limit of $288 million and an upper limit of $559 million.
The following are examples of HCCs that were not supported by the documentation that PacifiCare submitted to us for medical review:
* For one beneficiary, PacifiCare submitted the diagnosis code for “spinocerebellar disease, other cerebellar ataxia.” CMS used the HCC associated with this diagnosis in calculating the beneficiary’s risk score. However, the documentation that PacifiCare provided described an evaluation for fever and cough. The documentation did not mention cerebellar ataxia or indicate that cerebellar ataxia had affected the care, treatment, or management provided during the encounter.
* For a second beneficiary, PacifiCare submitted the diagnosis code for “malignant neoplasm of the prostate.” CMS used the HCC associated with this diagnosis in calculating the beneficiary’s risk score. However, the documentation that PacifiCare provided appeared to describe suture removal and left shoulder bursitis/tendonitis. The documentation did not mention prostate cancer or indicate that prostate cancer had affected the care, treatment, or management provided during the encounter.
* For a third beneficiary, PacifiCare submitted the diagnosis code for “unspecified septicemia” (commonly referred to as “blood poisoning”). CMS used the HCC associated with this diagnosis in calculating the beneficiary’s risk score. However, the documentation that PacifiCare provided noted that the patient was admitted for a “left total knee revision arthroplasty.” The documentation did not mention blood poisoning or indicate that blood poisoning had affected the care, treatment, or management provided during the encounter.
It has long been recognized that the private Medicare Advantage plans (offered as an option to the traditional Medicare program) have been cheating the taxpayers, initially by selectively enrolling the healthy while being paid at rates that include a mix of the sick, and, more recently, by gaming the process of risk adjustment (which seeks to correct for the health status of the beneficiaries actually enrolled by the private plans). This new report from the HHS Office of Inspector General is helpful because it provides a perspective of the enormity of the problem.
In one year alone (2007), one California insurer – PacifiCare (acquired by UnitedHealth Group in 2005) – used their Medicare Advantage program to cheat taxpayers out of almost half a billion dollars! Extrapolate that to all Medicare Advantage plans in all states for all years, and think of the impact this must have had on our Medicare budget.
The private insurers pride themselves on their innovations. Based on their past behavior, we can be assured that they will continue to innovate in opaque ways that cheat not only the taxpayers, but also the health professionals and institutions, and, most importantly, the patients. Without transparency, they will get away with it for extended periods of time, with new innovations introduced as they get tripped up on the old.
Although the Affordable Care Act calls for a reduction in overpayments to these plans, the legislation leaves them in place. That is a terrible mistake.
We need to shut down the Medicare Advantage plans, and, while we’re at it, shut down all private insurers and replace them with an improved Medicare for everyone. We may not be able to do that before we reach “The Cliff,” but we should start working on it immediately.
Healthcare crisis: not enough specialists for the poor
By Anna Gorman
Los Angeles Times, December 15, 2012
By the end of the decade, the nation will be short more than 46,000 surgeons and specialists, a nearly tenfold increase from 2010, according to the Assn. of American Medical Colleges. Healthcare reform is expected to worsen the problem as more patients — many with complex and deferred health needs — become insured and seek specialized treatment.
Many of the newly insured will receive Medi-Cal, the government plan for the needy as administered through the state of California. Clinics already struggle to get private specialists to see Medicaid patients because of the low payments to doctors. Last week, an appellate court decision that authorized the state to move forward with 10% cuts in Medi-Cal reimbursement, which could make finding doctors for those patients even more difficult.
“Specialists are paid so poorly that they don’t want to take Medi-Cal patients,” said Mark Dressner, a Long Beach clinic doctor and president-elect of the California Academy of Family Physicians. “We’re really disappointed and concerned what it’s going to do for patient access.”
In Los Angeles County, the sheer volume of poor or uninsured patients needing specialist services has long overwhelmed the public health system, creating costly inefficiencies and appointment delays that can stretch as long as a year and half.
Patients’ conditions often must be dire for them to see a neurologist, cardiologist or other specialist quickly. Community clinics try to bypass the backed-up formal government referral system by pleading, cajoling and negotiating to get less critically ill patients moved up on waiting lists.
At times, clinic staff members are forced to work against one of their key missions by sending patients to emergency rooms to increase the odds of their seeing a specialist more quickly.
My career in private practice began with the introduction of Medicare and Medi-Cal (Medicaid). At that time, I had no problems referring Medicare and privately insured patients to specialists, but the majority of them refused to see my Medi-Cal patients. The stigma of “welfare patient” was there right from the beginning.
Quite a few years later, my Medicare patients continued to be accepted without question, but some of the managed care patients were rejected, and, of course, Medi-Cal patients continued to be rejected, except by a few very dedicated specialists. Eventually with EMTALA, at least I could force unwanted referrals for patients requiring specialized emergency services by sending them directly to the Emergency Department. What a terrible way to practice medicine.
As stated in my last message, there will be about 10,000,000 Medi-Cal patients in California, once the Affordable Care Act is fully implemented. Can you imagine the specialists suddenly opening their doors and welcoming these patients into their practices?
I’ll say it once again. If we had an improved Medicare single payer system that treated everyone equitably, we would not have this problem.
Court ruling could cut California spending on Medi-Cal
By Maura Dolan and Chris Megerian
Los Angeles Times, December 13, 2012
A federal appeals court decided unanimously Thursday that California may cut reimbursements to doctors, pharmacies and others who serve the poor under Medi-Cal.
A three-judge panel of the 9th Circuit U.S. Court of Appeals overturned injunctions blocking the state from implementing a 2011 law that slashed Medi-Cal reimbursements by 10%. Medi-Cal, a version of Medicaid, serves low-income Californians.
The ruling could make it harder to find doctors for as many as 2 million new patients who could become eligible for Medi-Cal under President Obama’s healthcare law — a possible 25% expansion of the program. California already provides one of the lowest rates of reimbursement in the nation for medical services to the poor, and there is a shortage of doctors to serve those patients.
According to the California HealthCare Foundation, Medi-Cal patients already have difficulty finding doctors.
A foundation study published in July 2010 said 25% of physicians provided care to 80% of Medi-Cal patients.
Although 90% of physicians told the foundation they were accepting new patients, only 57% said they were taking on new Medi-Cal patients.
One of the major defects in the Affordable Care Act is that it perpetuates and expands the Medicaid program – a welfare program for low-income individuals. Because of political anti-welfare bias, it is vulnerable to budget cuts that would not be tolerated in a program like Medicare that benefits all of us.
California’s Medicaid program, Medi-Cal, exemplifies this problem. It has one of the lowest payment rates in the nation, not even meeting the expenses of many of the physicians still willing to see these patients.
There are already over 7 million Californians on the program, and there will be almost a million children added as California shuts down its CHIP program (Medi-Cal pays less than CHIP). There will be about 2 million more individuals added in 2014 under the provisions of the Affordable Care Act. Further, low-income Medicare patients also eligible for Medi-Cal are being transferred into Medicaid managed care plans.
In spite of California being at the bottom in Medicaid payment rates, this 9th Circuit Court of Appeals decision upholds the additional 10 percent cut enacted because of California’s budget crisis. The reduction was challenged based on the fact that federal law requires that the state ensure that Medicaid patients have access to adequate health care services, and underpayment reduces the number of willing providers. That argument was rejected by the court, though it is difficult to see how California’s physicians will be able to care for over 10 million Medi-Cal patients when they are effectively donating their services plus subsidizing their losses resulting from overhead expenses that are greater than reimbursement rates. As more physicians turn them away, the crowd out of privately insured patients will threaten the solvency of the few remaining dedicated physicians.
This underpayment has real consequences. Access to primary care is impaired, and specialized services are especially difficult to obtain since most specialists are particularly resistant to allowing these patients in their practices, no matter how great the need. Outcomes for Medicaid patients are not as favorable as for those who have Medicare or private insurance. In some studies, the outcomes are as bad as the outcomes for the uninsured.
What good is a Medi-Cal card if it won’t provide access to health care?
If we had a single improved Medicare that covered everyone, this problem wouldn’t exist. Everyone would have the level of care that we should expect from a high-performance health care system. Are there too many politicians who still believe that we should offer only inferior health care to the poor because that is all they deserve? The rhetoric of the recent elections doesn’t bode well for a more egalitarian approach.
Madrid’s physicians, nurses and other health professionals have been marching in the streets with their patients for over a month, protesting the government’s plan to privatize and sharply reduce public health services.
Spain’s National Health System (SNS), established in 1986, fulfills a mandate included in Spain’s national constitution. Article 43 guarantees healthcare to all Spaniards, including the right to adequate public health services.
The attack on the SNS is led by the government in Madrid. (Administration of the SNS is decentralized; each of Spain’s 17 semi-autonomous regions sets health budgets and priorities.) At the beginning of November Madrid moved to privatize ten percent of public health centers as well as the administration of six hospitals – half of the hospitals in the region. Of the hospitals to be privatized, all were recently built.
The response: an unprecedented and massive mobilization of people in Madrid, now making mainstream news across the world. Caregivers and patients together have joined protests at every public health clinic and hospital in Madrid. Marches have involved hundreds of thousands. Caregivers have gone on strike and stopped traffic outside their workplaces.
The Partido Popular, in power nationally as well as in Madrid, also proposed to convert La Princesa Hospital, a tertiary care center serving about 300,000 patients annually, into a specialty care center for patients over the age of 75. In addition to mass meetings and sit-ins at La Princesa Hospital, a petition in protest gained over 200,000 signatures. The Mayor of Madrid, herself a member of the Partido Popular, signed on. The government has retreated from its plans at La Princesa Hospital yet the struggle continues.
Last week a group of patients, nurses and physicians disrupted a speech at the Madrid regional Assembly, where the government’s economic counselor was explaining the hospital privatization plans. In this short news video, Dr. Marciano Sanchez Bayle chants for public healthcare beside a woman who unfurls a banner, the first to be led out by police. Note the Assembly members who stood to applaud the protesters.
Here is a short interview I conducted with Dr. Sanchez Bayle of the Federation of Associations for the Defense of Public Health (FADSP) this week.
In Spain the health system is public and coverage is universal. This means that when a person thinks he or she has a health problem, they go their public health center. There they are attended by a doctor and/or a nurse who will make the appropriate decision whether to diagnose and treat, ask for diagnostic tests, refer the patient to a specialist or admit them to a hospital.
Of course, if the situation is serious or occurs outside regular treatment hours, patients can go to a hospital emergency room. Hospitals are also mostly public. Thus far all of these services are free, including the tests. A patient does have to pay a share of the cost of their prescriptions, however.
On a per capita basis, the Spanish system is four times less costly than in the U.S. Yet we achieve much better outcomes, according to basic health indicators.
How has the government proposed to change this in Madrid?
The proposal in Madrid is to privatize some of the hospitals and health centers, turning them over to private businesses.
How will this affect patients?
There will be an immediate and significant downsizing of personnel, resulting in diminished access to care. It will undermine the quality of care. It will substantially lengthen waiting lists.
In addition, these changes will result in what we call risk selection, whereby private entities will seek out the most profitable pathologies, i.e. those persons who are less sick. As a result, people will face more obstacles to getting the care they need, following the Tudor Hart law of inverse care – medical attention will be dispensed in inverse proportion to the needs of the population.
These will be the short-term results, because it is clear to us that the Partido Popular, the conservative party, hopes to install a health care model based on private insurance. The disastrous results of such a model as the United States, are well known.
What will it mean to doctors and nurses?
First of all, there will be fewer of them employed, with layoffs and fewer facilities to practice in. For those remaining, it will result in overwork and a worsening of professional working conditions.
Please describe the protests that have emerged in response.
It would take a very long time to fully answer your question because there have been such a multitude of actions. Briefly, it has produced a strike by the staff of the centers — doctors, nurses, administrators, auxiliaries, etc. — which has been organized according to a rotating schedule, e.g. specific days a week. Health worker sit-ins, sometimes joined by patients, have also occurred. These started first in the hospitals, then in the health care centers. These protests have been going on for 30 days.
In addition, massive demonstrations have been held in Madrid, some with more than 100,000 people, professionals and patients. Every day there are demonstrations blocking traffic in front of the health centers. Last week an action was carried out under the slogan “Hug your Hospital,” in which human chains circled all the public hospitals of Madrid.
The most interesting thing is the supportive reaction of the citizenry. People are very committed to the defense of the public health care system. Of course, we Spanish continue to have a bit of the guerillero and anarchist spirit in us, so to speak, and many initiatives have been sprouting up like mushrooms.
What is the significance of the La Princesa Hospital in this struggle?
La Princesa Hospital is located in the center of Madrid. It has 600 beds and a high level of specialization. It is the referral center for many of the peripheral centers of Madrid and beyond.
The attempt to convert La Princesa into a geriatric center was the spark that lit the movement: the unions of the center started a sit-in which still continues. The sit-in has mobilized more that 90 percent of the facility’s workers. Citizens in the zone it serves have also joined in. The hospital’s governing council negotiated with some of the doctors, i.e. department heads, and the two sides arrived at an agreement which doesn’t seem bad. Yet the struggle to withdraw all the measures that affect health care in Madrid, including this issue, continues.
We have been hearing about many protests against austerity in Europe, in Spain, in Madrid. What is the justification used by the government to move to privatize the public system?
The government says that it’s the crisis and that there is no money, but it’s a lie. They have allocated 215,695 million euros to bail out the banks, and with these measures they say that they will save 7,000 million euros in health care. What they want to do is to use the excuse of the crisis to privatize health care, to put it in private hands in order to make a profit on the health of the people.
What is your view of this demand for austerity?
I have already said that they want to take away peoples’ rights in favor of the banks and private businesses.
Why did you disrupt the Madrid Assembly? Who was with you?
What we did was to try to demonstrate within the Assembly professionals’ and citizens’ rejection of this blatant act of aggression against health care. The elected representatives should not have deaf ears to the opinion of the immense majority. Keep in mind that the Partido Popular, now in government, didn’t include these measures in its election program. They gained their votes through trickery and are now attacking our public health care system.
What else would you like to share with people in North America about this struggle? What can we do to help?
The right to health care is a peoples’ right and should be defended as such. What is happening in Spain today may seem far-off to the people of the United States, but the world is globalized and interconnected. Every advance or retreat which happens in one part of the world has a repercussion for us all. Help can come in spreading word of the struggle so the problem is known, and also demonstrating solidarity through demonstrations in front of Spanish embassies and sending signed protest letters to entities and people in the government of Madrid.
Solidarity is very important, not only for those who receive it but also for those who practice it, because it makes us better people and benefits our common, concrete struggles.
Dr. Marciano Sanchez Bayle, a spokesperson for Spain’s Federation of Associations in Defense of Public Health, is also president of the International Association of Health Policy. He teaches and practices pediatrics in Madrid.
US backs United Nations measure in favor of universal health coverage
By Elise Viebeck
The Hill, December 12, 2012
The United States has backed a United Nations draft resolution favoring universal healthcare coverage.
The nonbinding measure calls on U.N. member states to ensure citizens’ access to health insurance, and was approved by the U.N. General Assembly on Wednesday.
Adopting Consensus Text, General Assembly Encourages Member States to Plan, Pursue Transition of National Health Care Systems Towards Universal Coverage
United Nations, December 12, 2012
Recognizing the intrinsic role of health in achieving international development goals, the General Assembly today – through the unanimous adoption of a resolution on global health and foreign policy – encouraged Governments to plan or pursue the transition towards universal access to affordable and quality health-care services.
By that text, the Assembly, calling for more attention to health as an important cross-cutting policy issue, urged Member States, civil society and international organizations to incorporate universal health coverage in the international development agenda and in the implementation of the internationally agreed development goals, including the Millennium Development Goals.
The Assembly also recognized that improving social protection towards universal coverage “is an investment in people that empowers them to adjust to changes in the economy and the labour market and helps support a transition to a more sustainable, inclusive and equitable economy”. As such, while planning or pursuing the transition towards universal coverage, Member States were encouraged to continue investing in health-delivery systems to increase and safeguard the range and quality of services and meet the health needs of their populations.
Further, Member States were encouraged to recognize the links between the promotion of universal health coverage and other foreign policy issues, such as the social dimension of globalization, inclusive and equitable growth and sustainable development.
Agenda item 123
General Assembly, Sixty-seventh session
Global Health and Foreign Policy
IV. Universal health coverage
56. Universal health coverage captures the aspiration that everyone will be able to obtain the high-quality health services they need without the risk of suffering severe financial hardship when using them. The goal of achieving universal health coverage has two important and interrelated components: coverage for everyone who needs health services (including prevention, promotion, treatment and rehabilitation) and coverage with financial risk protection.
57. Both components are critical to the fulfilment of the highest attainable level of health, a fundamental human right embedded in the WHO constitution of 1948 and in the Universal Declaration of Human Rights. At the same time, people value them for their own sake. They sleep securely at night knowing that the health services they might require are available and of good quality and that they can afford to use them.
Population figures by country
It is terrific that the United States has voted for a United Nations resolution in support of universal health coverage for all Member States. But what about the United States? The Affordable Care Act will leave about 30,000,000 uninsured, more than the entire population of each of 183 countries and territories. Oh, of course… the U.N. resolution is nonbinding.
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