Wednesday, April 30, 2014

Health Care - There Are Two Americas

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In a follow up to the last post, a piece in the Huffington Post looks at the two vastly different Americas that are emerging in the context of health care and avoidable deaths.  Liberal states are seeing more access to health care for their citizens while Republican controlled states, especially in the Bible Belt, where access to heath care is restricted and where otherwise avoidable deaths are higher than in the rest of the country.   The take away: (i) the GOP is waging a war on the poor, and (ii) the godly folks of the Bible Belt are major league hypocrites since they support the GOP's war on the poor.  Here are article excerpts:

When it comes to the quality of health care, there are two Americas.

In one America, infant mortality, avoidable deaths, health-care costs and other measures are far worse than in the other America, according to a new study by the Commonwealth Fund, a health policy research firm. And thanks to Republican lawmakers and the Supreme Court, the gulf between them may only get wider.

The map below from the Commonwealth Fund shows the stark divide. States with the worst overall health care systems -- as measured by factors like the number of insured adults and children, avoidable emergency room visits and access to affordable care -- are dark blue. States with better health-care systems are white.

Millions of lives could be saved if the low-performing states could close just half the gap with the top states, Schoen said. "We really need to stay focused on aiming higher.”

Many of the lower-performing states have higher rates of early deaths that could have been prevented by access to quality health care. The Commonwealth map below shows the number of avoidable deaths per 100,000 in each state. 

Avoidable deaths

Many of the worst states for health care have several things in common. They’re mostly in the South and are more likely to be among the poorest in the nation. Many of them have long had unusually tight standards for applicants to qualify for Medicaid, said Schoen, and many have been slow to expand children’s health insurance.

What's more, 16 of the 26 states at the bottom of the Commonwealth Fund’s scorecard aren’t expanding Medicaid under the Affordable Care Act . . .

Increasing access to Medicaid isn't a cure-all for low-performing states, and improving health care outcomes overall will require more than just expanding Medicaid. But it could help, Schoen said. For one, it will extend health coverage to more people, making it less likely that poor patients will head to the emergency room for things other than emergencies. And if more low-income residents can pay for health care, more doctors might be convinced to move to poor or rural areas.

Black Americans are likely to suffer disproportionately from these policies. More than two-thirds of poor, uninsured blacks live in states not expanding Medicaid, according to a December 2013 New York Times report. Already, the rate of avoidable early deaths among blacks is twice as high as among whites in many states, Commonwealth found.

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