The Best States For Health Care
A new report has been published that ranks the quality of health care for all 50 states and the District of Columbia. It's not looking too swell for people who live in the South.
One of the most disturbing findings from the report is that "in 1999-00, there were only two states with 23 percent or more of adults uninsured. But by 2007-2008 there were nine."
Vermont took first place, and was praised for its extensive preventative health care program:
The Green Mountain state was cited for its model "Blue Print" program. Launched by Republican Gov. Jim Douglas, it covers everything from teaching children healthy eating to helping seniors stay in their homes rather than going to costly nursing homes.
"You betcha, I feel good about the reforms we put in place," Douglas told ABCNews.com. "It's centered on quality and containing costs. Care shouldn't start in the emergency room."
All Vermonters are encouraged to have yearly exams and adults are notified when they are due for check-ups.
Compare Vermont's outreach with Mississippi's stringent "face-to-face" eligibility requirements for Medicaid benefits, which is partly what put it in 51st place:
Despite one of the highest matches of federal to state dollars in Medicaid funding, the state mandates "face-to-face" eligibility, requiring all new applicants and those reapplying for benefits to come in for an interview.
"As a direct result, 65,000 children have fallen off the rolls," [Mississippi Health Advocacy Program director Roy Mitchell] said.
"Mississippi does virtually no outreach at all. They don't publish where these face to face stations are and what times," he said. "It's a bureaucratic maze even to find out where to go. And when they get there they don't have a certain document."
Of those, about 77 percent would be eligible, he said. "It's touted as fraud prevention."
Whatever, we're moving to Hawaii. It was ranked #2, and it's got volcanoes!
You can look at an interactive map of the state rankings here.
"Vermont, Hawaii Top Health Care Scorecard" [ABC News]
"State Scorecard 2009" [Commonwealth Fund]
Post a comment
Comments:
@tbax929 is back from the beach:
Wow. What am I saying?
There is a correlation between having insurance and the type of healthcare you receive.
Sorry.
Alabama's Health Motto "{Let em die, and let God sort em out as long as we don't lose a nickel". The Red party controls the state and it's resources.
It got clipped off but there's a massive super dark blue Canada-shaped polygon at the top.
Okay I tease because its fun. We have our ups and downs, I don't consider ours Universally better. Haaa that's another pun.
Hawaii, good job, surprised the hell out of me...
So according to this color-coded map, Chicago residents would get better health care if they moved to Lake Michigan. Sounds about right.
Huh. Other than Alaska, Hawaii and the occasional slight exception, it's a spectrum from white to dark blue going from north to south ...
@Mackinstyle:As a geographer/cartographer I have to complain about this choropleth map. You NEVER make white good and a dark colour bad. Ever. Not even white/black. So I mean't to say the polygon would be white.
Which is weird, considering the number of healthcare companies based in Tennessee.
So... you're telling me the people opposing health care reform are from states that need it the most? I'm not sure if that's surprising, or surprisingly predictable.
That's fairly informative. I'd actually like to see it cut up by county, as well- I'm curious where Miami-Dade county here in Florida lands. My hospital is a public health trust, so we cover virtually everything that comes through our doors, insurance or not.
@tbax929 is back from the beach: I had the exact same thing done to me. Our first we had state subsidized insurance (hey I was just finishing college) and they treated me like absolute crap. Hospital staff were openly mean when they were even around. Our second when we had really good insurance it was like being in a 4 star hotel with people waiting on you hand and foot.
I find this kind of discrepancy disgusting.
Health care in SD is what I would consider pretty crappy. What I experienced in California was much worse. I really do not even want to know what it is truly like in the South.
@bohemian: Would you be surprised to know that repeated studies have proven that VIP medicine- that is, giving special, preferential treatment to certain patients- is actually worse FOR THOSE PATIENTS? Politeness & fanciness not only does not equal better outcome, but often a worse outcome.
Given that, the "disgusting" part of it could well be that more people aren't treated with irritation by staff :P
@Smashville_not taking it seriously:
The number of credit card issuers based (on paper) in Delaware and South Dakota doesn't mean you get a better deal on your Visa card in those states.
Alaska would probably be better if it wasn't for the villages. Seriously, they have third world health care. Makes sense, though...imagine every nothing town in the middle of nowhere you've ever seen in the US. Now add 1000 tons of mosquitoes and remove all the roads, and make it balls-ass cold for 6 months of the year so everyone stays inside breathing each others' breath all day.
They're a self-sustaining reservoir of tuberculosis that constantly reinfects the rest of the state.
Why, oh why is NH ranked #5? Anytime I have been in need of health care, it has always been a joke. Finding a job with insurance, never mind actual USEFUL insurance has grown well nigh impossible over the past several years.
"Don't have insurance? Sorry, we don't want to help you. Go somewhere else." Yes, my dotor's office actually said that to me. My god, i'm willing to make payments over time when I can, sheesh. Stop treating me like I have the plague or something.
And don't even get me started on my OBGYN, whom I won't go see ever again, I'll find someone else, eventually when I have decent insurance so I can afford to go. Right about... probably 5 years from now x_x
@bohemian: I had it happen, too. I had just relocated to a new state and hadn't settled into my new job yet so I was without insurance. (My own fault, I could've paid for COBRA but I didn't) I couldn't believe how awful I was treated when my tonsils flared up and was sent to the emergency room by the urgent care doctor. In the end they didn't do what the urgent care doctor wanted them to do probably because of my lack of insurance. It kind of pissed me off because I got pain killers and antibiotics for my trip there and I could've gotten that from the urgent care doctor, yet the urgent care doctor said I needed an emergency tonsil removal.
Am I the only one that is bothered that it is 1999-00 and not 1999-2000 (especially since it says 2007-2008 rather than 2007-08.)
@TechnoDestructo: Tons of mosquitoes?
Noooo! I've always fantasized about hiking through Alaska in the summer; I had hoped that mosquitoes were limited to to areas at least closer to the Equator. :(
Iowa tied for #2 with Hawaii, and on the way up from #3, while Hawaii slipped to trade places with old #2 Vermont. This means that Missouri ranks 32 places below an adjacent state, as does Alaska with its large indigeneous population if you count Hawaii as a bordering state, tying for #2 in the adjacent states delta rankings (TM 2009 by me).
Number 1 and #3 in that ranking goes to Illinois, 40 places shy of Iowa and 32 below the more valid comparison of Wisconsin, which swaps workers with Chicagoland.
Adjacency tends to be a major influence here, as I would expect from the importance of employment to health insurance coverage. If the Iowans and Wisconsinites who work in Illinois had some say, maybe it would have a better system instead of counterfeits like the "Urban Health Initiative."
* I favor a voting system where someone who resides in A and working in B gets some say both places, while someone living and working in C would get more say than someone who only lives or only works there.
I've lived in, and received healthcare in 3 of the bad states (Kentucky, Florida, Texas.) Florida emergency rooms are overcrowded and poorly run, at least in the Miami metroplex area. Other than that I saw nothing amiss, and I think that could be attributed to the very high population density in the region.
Kentucky and Texas both seem to give great care. The study seems to be rating how many people have insurance coverage, not what the actual medical care industry is doing.
It's kind of obvious that the poorer states are going to have less people with insurance. That doesn't mean the doctors and medical professionals aren't doing their jobs.
@Alex Morse: You're dead-on correct about Miami.
Without making excuses, though, I just want it out there that it's actually the case managers & 1-2 triage nurses who supervise the ER at my hospital (the biggest one here); not the Doctor. :(
Ironically, I've never visited the US states for health care. I've never needed "real" health care like surgeries, but I usually just head south of the border and it's great.
I think that states whose senators want better health care should get it and states whose senators don't shouldn't. That would bring downs costs and get health care reform passed quicker.
/I don't really think this way but I might soon
I live in hawaii. We rock.
@Smashville_not taking it seriously: Health care companies do not equal better health, as people are increasingly discovering.
@CompyPaq: I have a problem with your plan! Joe Wilson, Jim Demint and Mark Sanford already screw up things for us enough down here, we don't need to miss out on health care reform.
Funny how the worst states for for the people that so completely against real health care reform...
Do you know WHY the south has such lousy health care? One of the biggies is the fact that we pay for MILLIONS of illegal Mexicans who can simply walk across the border and have more rights and "freebies" than we, the tax-paying citizens. As a Texan (and a hospital employee), I've seen this happen thousands of times in my own hospital. Walk across the border in labor, report to the nearest ER and deliver yourself of an anchor baby. If your baby isn't perfect, you've hit the lottery and can sue the hospital for millions - even if it was your fault that you never had any prenatal care and just showed up as a "bomb" in the ER. GRRRRRR
@Gracegottcha: I don't think there are too many Mexicans in Mississippi but I wouldn't be surprised if there was a racial element to the face to fact requirement, something like they used to do with voter registration. I think Mississippi ought to have "The 51st State" on its license plates. I mean it seems to be dead last in everything.
@Gracegottcha: I would like to be introduced to the Texas jury that would award "millions" to an illegal Hispanic immigrant who says "my baby isn't perfect". Even pretending, of course, that Texas law allowed such a thing and that any Texas lawyer could afford to take the case. Y'all passed tort reform, remember?
You need to stop getting your facts from pulledoutofmyass.com.
@Gracegottcha: I seem to remember seeing (and hearing about) the "Mexicans" paying their maternity bills in cash. (I use "Mexicans" because, really, everyone with brown skin is a Mexican in Florida and most of the Southwest).
Then again, I also remember companies hiring people whose papers weren't real and sending them to the ER after a work accident and telling them to say they hurt themselves at home instead of at work. You know, to avoid paying workman's comp out of pocket. Because their claim would be denied since their paperwork wasn't legit.
Soooo, who do you go after first? The businesses who rely on the cheap labor thereby passing the savings on to you OR the people who are supplying the cheap labor and trying to get fixed so that they can continue to supply the cheap labor?
By the way, I worked both ends of this at the hospital and at the business (construction, of course, during the housing boom).
Not surprised with Ohio (where I live now) vs. New England (where I live for most of my life). I'm struggling to find even halfway decent doctors here, while I had absolutely excellent ones in RI. Similar insurance plan (BCBS PPO), too.
@mythago: I'm glad you asked.
It's been known as far back as 1964:
Here's a modern one from the American College of Chest Physicians.
For anybody else that's curious, if you ever want to actually read what we read in looking up medical information, UpToDate is really the best way. That said, it requires a somewhat expensive subscription, so you can go right to the journal source at NCBI Pubmed. I'm actually a published author in the Journal of Craniofacial Surgery, so that's kind of a plug, too :P
The lesson, ladies and gents, is simple- maybe you shouldn't push for VIP medicine.
I'd like to take CT off that good care list. The difference between medical care and being able to pay for care leaves a huge gap here. Maybe the hospitals and doctors ARE great (I mean hey we have Yale we should be golden right?) but paying for them is pretty difficult in many cases when so many of them don't take Charter Oak or SAGA and SAGA has such a low standard of acceptance in comparison to the average income.
A married couple working full time at minimum wage blows right past federal poverty levels but comes up to less than half (take home) of the average income for the state and a little more than a third of the average income for the most expensive county. The county's avg. income is $65k which is ten over the state avg. AND if you take out the poorest town you can add another 10-15k to the average. So when you meet the federal poverty standard for a family of 8 but you're only two people you're kind of SOL.
So while that's really great that we got lumped in with having a great standard of care because we're in New England, as a resident of this state I would like to point out that affording that great care for the other 2-3m people in the state isn't so easy and money available goes a long way into making that care rating what it is.
@FrugalFreak: Blue Cross Blue Shield has 90% of the health insurance business in Alabama. Place blame where it belongs, at their feet.
So glad I'm leaving Texas and moving back to New Hampshire. New England FTW!
@mythago: The link provided from the ACCP also has, at the end, links to even more studies showing the same thing- and that's only from 1993! In medicine, we frequently discuss the bizarre reality that research often takes decades to be put into practice. In this case, it's just now being acknowledged in many hospitals.
Shocker! The states represented most by obstinate college drop out GOP Senators (ah yeah that's the South) have the worst health care. Well at least the gays can't get married. Tricking people to vote against their own best interest ever since the 1954 Civil Right Bill. Cowboy up!
There is defiitely a havig insurance and the quality of healthcare you receive.
My sister had a child when she was uninsured, and the hospital treated her like crap (since they assumed they'd never get any of the money they were spending to take "care" of her). For her second child, she was well insured, and the same hospital treated her like a queen.