Opening - Prez J.

Invocation - Bob Statler

Flag - Rick Crane
Song Master - Pastor Greg Hickman
Guests and Visiting Rotarians - Bob Maxwell
David Grubbs - Jim Blake
Matt Apadaca - Scott Dowds
Gregory Haeseler, Long Beach Rotary - Scott Dowds

Announcements: Called by Prez J.
Minard Duncan - Saturday's Rotary Clinic was very successful. 78 children received dental procedures.
Jim Williams - Bill Peloquin is ill but apparently doing o.k.
Leslie McCarthy - Thanked Top 100 helpers at the Fullerton High event.
Pat Hartnett - Thanked those who donated to Rotary International, and announced that an Angel baseball game to support End Polio Now is coming up.
Theresa Harvey - Explained that parking was crowded today because of a Racket Ball Tournament for the world's top athletes.

Recognition Master Dick Daybell did a great job today by fining Rotarians for: Not wearing Rotary badge - J. Richey and Bob Jahncke
Being a 10 year member - Bob Clark, Minard Duncan, Chris Meyer, Leslie McCarthy, Debbie Napolin
Being a 15 year member - Griff Duncan, Bill Mathy, Don Lugwig, Wally Swatkowski
Being a 20 year member - Bill Heaton, Phil Silverman
Being a 25 year member - Buck Catlin, Dan Fisk, Dan Kiernan, Mark McGee, Nate Kvetny
Being a 30 year member - Bob Statler
Being a 35 year member - LeRoy Fulton, Bill Gorman, Dick Mathewson

Raffle - Zoot Velasco
Miko Krisvoy and Leslie McCarthy had to answer one of three current event questions asked by Zoot. They correctly answered the third question which was "Texas passed a law against lying about what?" Would you believe the answer is "Size of bass."

Program - Introduced by Keith Mills

Our speaker today was Professor Sean Flynn of Scripps College in Claremont. He does research in the field of Behavioral Finance and his topic today was “How Singapore Delivers the Best Medical Care in the World (While spending 80% less than we do).”

He began by comparing the U.S. Health Care system with those of Great Britain and Canada. All three are what are called “Third-Party-Payer” systems. That is, the bill is not paid directly to the physician or the hospital or other health care provider directly by the consumer (patient) but by a third party who has assumed responsibility for the bill. In Britain and Canada that third party is the government. In the United States it is an insurance company until the patient is old enough to qualify for Medicare, when the government takes over.

Both Britain and Canada ration health care through governmental agencies which have the power to deny any particular medical procedure on the basis of a cost-benefit formula. These agencies have earned the term “death panels” in the current American political debate. The British and Canadian agencies have the power to say “no” to any treatment deemed too costly and make it stick. Insurance companies in the U.S., on the other hand, are regulated by state insurance commissioners who have to run for re-election every few years, and who are responsive to voters’ demands for ever increasing areas of coverage. The upshot of this system is that the United States spends over 18% of its Gross National Product (GNP) on health care. Britain and Canada spend nearer 12%. Singapore spends – are you ready for this? – only 4%. That’s about one-fifth as much proportionally as we do in this country.

Dr. Flynn then gave a brief history of how we came to rely on employer-provided health insurance to pay for our medical bills. When you think about it, isn't it strange? Unless you’re on active military duty you don't depend on your employer to provide your food, shelter, or clothing. Why medical care? It all started during World War II when all commodities were scarce and the government instituted rationing along with strict price and wage controls to prevent runaway inflation. That meant that employers could not use the promise of higher wages to attract employees. A west coast steel manufacturing and ship-building company trying to get workers to move to California from the east coast offered free medical care as part of the employment package. It worked. Workers applied in droves. That company was Kaiser Steel in Fontana, and the medical plan was the precursor of the Kaiser Permanente health care system that is so successful today.

The idea, if not the actual plan, was copied by employers all over the country, and, after the war, the federal government encouraged its extension by its tax policies: i.e., not taxing employees for their employer-provided medical benefits, and allowing employers to deduct the cost of employee health plans as a business expense. We've been locked into this system ever since.

In Singapore they combine a certain amount of government direction with free-market incentives to achieve an optimum result of providing excellent health care for all, at affordable rates, giving each consumer a free range of choice, with no one left out. To begin with, all persons who are employed are required to put 6% of their income into a Medical Savings Account, and to purchase a high-deductible, catastrophic medical insurance policy. Then everyone is free to spend that medical account on their health care in whatever way they think best. You could spend it on yourself, your spouse, your children, siblings, or elderly parents, if you wish. Doctors and hospitals provide price lists for all their procedures, and the patient (consumer) has a choice of the services to be selected, or not. Even hospital rooms range from rather cheap 8-bed open wards to luxury accommodations managed by a world-class, five-star hotel. The government taxes the high-priced options, and so, by “selling up” to the rich, the system attracts funds which can be used to subsidize the poor. (If you are poor and nave no health savings, the government picks up the tab.)

The result of the free-market exchange for medical services is that these services are provided at competitive prices. When competition is allowed, prices fall, as has happened in this country with Lasik eye surgery which is not covered by Medicare or insurance. Once very expensive, it has become much cheaper – and better – as eye surgeons have innovated to reduce costs and provide a quality product.

If such a system were installed in the U.S., Dr. Flynn estimates that the savings on Medicare alone would balance the federal budget.

Dr. Flynn received his Bachelor’s Degree from U.S.C. and his Ph.D. from U.C. Berkeley where he studied under George Akerloff who received the Nobel Prize in Economics in 2001.

If you would like to hear a more detailed version of the Singapore Health Care Plan you can go to the following link and listen to a 50-minute podcast there.
http://media.scrippscollege.edu/scrippscasts/sean-flynn-how-singapore-delivers-the-best-medical-care-in-the-world-while-spending-80-less-than-we-do