There were 28 members present and no guests.
Announcements: Tom Nash reminded everyone that we have no meeting on Thanksgiving Day and that our December 7th meeting will feature the New Trier Swing Choir. Brooke reminded everyone that November 30 is the deadline for our community grants applications. Barb said that we need 7 or 8 more volunteers to help the Glenview Youth Service organization wrap gifts for needy children on December 8th. This service would be needed from 2:00-3:00 and volunteers should contact Barb for the details.
Happy Bucks were given by Ned Misner for his successful presentation on planned giving before the Northbrook Rotary—which, by the way, added a 5th “four-way test” which is to “have fun” as a Rotarian. Rich Lalley contributed due to the help received by Tom Nash and Fred Schwimmer in delivering coats for kids. David Birkenstein contributed because the Club’s recent get- well card to his wife, Mary, meant so much to both Mary and David.
SPEAKER: Peter W. Butler, Professor and Chairman, Department of Health Systems Management at Rush University (Chicago). Mr. Butler was introduced by David to give us an update on this Country’s evolving health policy landscape. He pointed out that the tax reform effort has involved the individual mandate under ACA. Revoking the requirement that everyone buy health insurance would save the government about 300 billion dollars. He said that health insurance is becoming the most important issue, as evidenced in Virginia where 37% of the recent voters said that it was their number one priority. Even states that opted out of extending Medicaid due to the potential cost are now rethinking that decision—Maine residents recently voted in a ballot initiative to have the state extend such coverage. Recent surveys show 60% of our population think that health insurance coverage is the responsibility of the government and 66% think that ACA should be amended, not repealed. These issues along with spending caps, DACA resolution, border wall funding and hurricane relief will all be part of the upcoming government funding bill which needs to be resolved by December 8th.
Mr. Butler’s power point indicated that there are 55 million people on Medicare; 74 million on Medicaid; 155 million that have employer-based insurance; 18 million who get insurance on the exchanges (about 6% of the total); and 30 million don’t have any coverage. He said that ACA works for most everyone except the 6% that use the exchanges, which is the part provided by private insurance companies. He said that the Republican bills to get rid of the individual mandate would save about 300 billion by not paying subsidies and that they would argue that that would cut the cost of the proposed tax reductions in their tax reform bills. He said that eliminating the mandate would result in the number of current uninsured of 30 million to increase to 43 million immediately and to 49 million in the next 10 years. This would also raise the premiums paid by those using the exchanges by at least 10%.
Surveys show that healthcare costs in the U.S. are double those in other developed countries, but that out health outcomes (life expectancy, infant mortality and safety during childbirth, asthma and diabetes) are 30% or less effective than such countries as Switzerland, Iceland, Italy and Poland. The reason for our high costs is that our hospitals pay higher salaries for doctors, nurses and other professionals, and spend more for capital improvements, medical devices and drugs. Our Medicare program pays the market rates for drugs, which is much higher than what our Medicaid and VA programs, and other countries pay. (One of our Club members mentioned that she was able to reduce the cost of her employer plan by buying drugs in Canada which were 1/6 of the cost in the U.S.) Mr. Butler said it takes too long for generic drugs to be available to the public and that virtually everyone wants to reduce drug costs, except for the pharma industry and their lobbyists!
Mr. Butler then mentioned that our citizens’ life expectancies and personal health are determined more by environmental factors such as diet, jobs and education than by the availability of healthcare services and street violence. He said you can predict expectancy based on zip codes even though they may be adjacent areas in the same city. For example, there is up to a 16 year difference in expectancy between people living in the Chicago Loop and near-West neighborhoods, where Rush is located.
Mr. Butler predicted that the 2018 national elections will have a lot to do with where the country goes with these problems. He reviewed the number of Republicans and Democrats up for re-election in the Senate and the Republican majority in the House and said that it will be another close vote. In Illinois, he thought Pritzker had the edge to win the governor’s spot. He ended his presentation by saying that he hoped that we didn’t give back to the states the money and responsibility to run their Medicaid programs and that the ACA should be revised, not repealed.
Mr. Butler’s power point presentation is available by clicking the following link: