OKLAHOMA: DEAD LAST IN HEALTH CARE!!!

[Route66Kid]

Maybe not dead last.  We can all take solace in the fact we are tied for dead last with Mississippi.[!]

Seriously, what can we do to move our state up out of last place in a few of the indicators used in this study?  

Any thoughts?  

http://www.businessweek.com/print/technology/content/jun2007/tc20070611_418189.htm

Science & Technology June 13, 2007, 12:01AM EST text size: TT
The Sorry States of Health Care
A state-by-state study shows who has the best and worst grades on 32 health indicators, and even the best are none too good
by Catherine Arnst

If you live in Hawaii, you're not just tanned and relaxed, chances are you are also better placed, health-wise, than the rest of the country, and certainly than the residents of Mississippi and Oklahoma.

That's the determination of a new survey by the nonprofit Commonwealth Fund that ranks the health-system performance of all 50 states plus Washington, D.C. Hawaii comes out No. 1 in the rankings, while Mississippi and Oklahoma tie for last place. The researchers conclude that if all the states could reach the low levels of mortality achieved by Hawaii, some 90,000 fewer deaths before the age of 75 would occur annually.

The U.S. health-care system is, just like the nation, a federalist entity, made up of 51 distinct health-care systems—the states and Washington, D.C (see BusinessWeek.com, 6/12/07, "Universal Health Care: Say Yes"). The states have tremendous authority on how medical care is delivered, monitored, and paid for within their borders.

They regulate both hospitals and insurers, deliver public health services such as vaccinations, and determine which residents are covered under Medicaid and the State Children's Health Insurance Program (SCHIP). Some states are also far ahead of the federal government on health-care reform. Maine and Massachusetts, for example, both have universal health-care laws in place, while California and several other states are considering similar legislation. (See our interactive table featuring the Commonwealth Fund data for each state.)

Dismal Percentages
New York-based Commonwealth Fund, a nonpartisan group that does health-care research, decided to issue a report card on how each state is doing on health care as a tool to identify areas of success and failure. Its researchers measured each state on 32 indicators, such as the percentage of people insured, the number of adults who receive screening and preventive care, hospital admissions for people with chronic illnesses, infant mortality, deaths from treatable cancers, and equity-of-care gaps by income and insurance status.

One stark finding: Even in the best states, performance fell far short of optimal standards. The percentage of adults age 50 or older receiving all recommended preventive care ranged from a high of 50% in Minnesota to a low of 33% in Idaho, while the percentage of diabetics receiving proper care ranged from 65% in Hawaii to 29% in Mississippi.

The problems with state health-care systems go far beyond the level of uninsured residents, says Commonwealth President Karen Davis, an economist. "The states have started moving into a leadership position on access to care by making health insurance affordable and mandated, but they can't figure out what to do about the cost and quality problems." Davis says she was particularly surprised by the wide variations among states on many of the measures—sometimes a 20- to 30-point difference between the best and worst states.

Focus on Hospital Admissions
The study highlights some of the reasons behind the high cost of health care in the U.S. by measuring avoidable uses of hospitals and medical care. Rates of potentially preventable hospital admissions ranged from more than 10,000 per 100,000 Medicare enrollees in the worst performing states to 5,000 per 100,000 enrollees in the five best. There was also a twofold variation in rates of readmission within 30 days of leaving the hospital (from 24% in Louisiana and Nevada to 13% in Vermont and Wyoming). Such rapid readmissions to hospitals is often a sign that care was not delivered optimally the first time.

The researchers estimated that if all states could reach low levels of preventable hospital admissions and readmissions for Medicare recipients, hospitalization rates for senior citizens alone could be reduced by 30% to 47% and save Medicare $2 to $5 billion a year.

Hawaii, incidentally, does not come out on top simply because it is paradise. It was the first state to expand access to health insurance, back in 1974 when it passed a law requiring all employers to provide health insurance to full-time workers. "Though we also think it's the healthy living," says Davis. All of the data compiled for the state scorecards can be found at cmwf.org.

See BusinessWeek's slide show of the best and worst states for health care, and join a debate about nationalized health insurance.

Arnst is a senior writer for BusinessWeek based in New York.
________________________________________________
U.S. State rankings of health systems performance:
http://bwnt.businessweek.com/interactive_reports/state_health_performance/

[Conan71]

My thoughts?

(Not lampooning you, just the story)

That story was about as well-written as an investigative piece in a high school newspaper.  

Any study can come up with multiple conclusions depending on what areas of data you want to analyze and assume are relevant to arrive at a pre-determinted conclusion the researcher wishes to arrive at.  I'm willing to bet there is some aspect of healthcare which would show Oklahoma as the best and Hawaii as the worst.

The conclusions don't mention whether or not there are just simply some people who refuse to go to a doctor until they are so sick they wind up in the hospital.  They also don't take into account people not taking care of themselves.  I believe Oklahoma is still one of the more obese states and we have a lot of smokers as well.

No, I don't take much to heart on these studies.  Sounds to me like they are trying to draw the conclusion that UHC is the panacea for health care.

[Hometown]

Tied for last place in healthcare?  Like I've said before Oklahoma has ground down to the level of a third world country.  How to grind our way back up the ladder?  I suggest increasing the income tax and making it more progressive.  Eliminate the sales tax on groceries.  Encourage the development of unions.  Vote Democrat.

What are the chances of this happening?  Short of determined and focused leadership, I would say – none.

My guess is that the best shot Oklahoma's middle and working classes have of ever rejoining the mainstream of life in the U.S. is for a new zeitgeist to arise on the national level, a new movement and a new mindset powerful enough to override what is happening at the local level.  

Knowing Oklahoma, she'll hang onto the ragged end of the Reagan era long after the rest of the U.S. has said, enough already.  It's going to take a powerful new intellectual movement from outside to change Oklahoma.

Meanwhile, life is cheap in Oklahoma, despite all the carrying on about a culture of life.

[Conan71]

quote:Originally posted by Hometown

Meanwhile, life is cheap in Oklahoma, despite all the carrying on about a culture of life.

Pretty much sums up why you are still here with your tired old rants on Oklahoma.  Eh, HT?

[YoungTulsan]

The whole healthcare system is jacked up from the core.  Should be overhauled and redesigned majorly.  Perhaps being currently at the last place gives us the best opportunity to revamp it totally without being too far invested into the current BS scheme.

We could start by promoting health, educating the public about being HEALTHY, and not needing billions of dollars to treat their preventable sicknesses, as well as preventing them into getting addicted into billions of dollars of big pharma drugs.

Before you resort to the easy answer "Raise taxes" or "throw more money at it" - You need to look at just WHAT you are throwing money at.

[cannon_fodder]

Again to my old standby - the government does nothing well even though they spend more money.  On top of that, I do not trust them. So why would I want to pay more for worse care from someone I don't trust?  Unless you trust the government and believe they can do a better job at health care than anything else they do and for some reason there will not be mass corruption, pork barreling, waste, and fraud... then even the suggestion is a waste of breath.

That aside, Oklahoma's health care is probably BETTER than most of the nation.  Simply because we live such unhealthy lifestyles they have plenty of practice.  Now go pad the top in the nation in fast food stats some more and go back to sitting on your couch.  Nothing to see here.

[guido911]

YT: "[A]ddicted into billions of dollars of big pharma drugs." ?? Exactly which "big pharma" drugs would those be? Is this another dig against Vioxx or Phen Fen? Or, are you commenting on those drugs that have extended the life expectancy of diabetic, AIDS, or heart patients.

CF: Good points on the article. I thought the same thing when I read it.

[Hometown]

"Perhaps being currently at the last place gives us the best opportunity to revamp it totally without being too far invested into the current BS scheme."  Good point, YoungTulsan.

To begin a discussion about this issue we have to go back to basics – really basic.

Mr. Fodder, Who else can do government's job?  No other entity is charged with looking out for the community's self-interest.  After 30 years of Republican bashing of government, Katrina showed even the Doubting Thomas' out there that government has a role that no one else can fulfill.  Republican cutting of government oversight and regulation has been nothing more than an invitation to crooks to gouge the public.  And boy have they ever.  But others have gleefully joined in with the crooks.

I'm reminded of a conversation I had with my well-heeled neighbors.  I was talking about demolishing a structure on a piece of property I was considering buying.  They told me that if I was smart I would let the city demolish the structure, like they had done with their's.

I thought about this later, and I thought what is smart about wiggling out of my responsibility and asking all of my neighbors and the rest of the city to pick up the tab for work that would primarily benefit me?  

What kind of future do we have when the people at the top of the heap think that it is a virtue to shift their personal responsibilities to the back of the community?  What can we expect people at the bottom of the heap to do when their leadership has no character at all.

So after thirty years of short changing community life, there isn't a lot of community life left.  And the burden of supporting what community we have left is disproportionately assigned to the middle and lower classes.

To even begin this conversation we have to understand that each and every one of us has a responsibility to pick up our share of the burden of supporting our community.  That's all that taxes are:  Your share of that burden.

[cannon_fodder]

HT -

I do not have a problem paying taxes.  I have a problem when I see that tax money wasted as it all too often is.  You gave a great example in tearing down a property so someone can make money off of it.

There are some thing government is the most qualified entity to do.  Defense, police, road construction, international trade regulation - and there are many areas that the government is NOT qualified to do nor particular good at.  Nearly all the grand social programs in the world end up going badly.  You mentioned Katrina, where the help did not arrive for several days and when it did the effect was minimal.  When it was all said and done they lost $500,000,000.00 and have document evidence that much of their expense has gone to strip clubs, alcohol, and other nefarious items.    For the cost of the 'cleanup' we could have cut a check for $100,000 to every resident of New Orleans and said "sorry."  You mentioned this to support the fact that government does a good job?

Social security will fail soon.  Our current socialized medical system (medicaid and medicare) does not fund procedures that people want, have wait times, offer lesser quality care, and cost more per visit while paying medical facilities less.  Certainly not a resume to EXPAND their responsibility.

and gouge the public?  That's what government does best.  Republican, Democrat, despot or dictator - they all go bad and try to fleece their 'fair share.'  For some reason you think giving them more money and power will stop that?    The larger and more powerful a government is the more corrupt, wasteful, and freedom quashing it is.

But anyway, I pay my taxes.  I watch my money float into democratic congressman's freezers and to republican senators bridges.  And the poor guy down the street from me - he doesnt pay any damn taxes, so dont tell me he carries a disproportionate load to my middle class tax paying self.  You keep pretending that the poor are somehow taxed more than everyone else, I'm too tired of it to post the numbers that show otherwise over and over.  More than 50% of American's no longer pay more in income taxes than they get back...

[Conan71]

quote:Originally posted by Hometown

I thought about this later, and I thought what is smart about wiggling out of my responsibility and asking all of my neighbors and the rest of the city to pick up the tab for work that would primarily benefit me?  

Holy crap!  Stop the presses!  There might be some Republican in you after all!  

Why don't you apply that logic to people who are purposely abusing the system every day in other ways?  Has it ever ocurred to you that our government largesse enables and encourages a lot of able-bodied people to be lazy and not take care of personal responsibility?  

quote:

To even begin this conversation we have to understand that each and every one of us has a responsibility to pick up our share of the burden of supporting our community.  That's all that taxes are:  Your share of that burden.

Yet the people who are the biggest burden contribute the least to the system.

For some reason you are still of the mistaken impression that politicians and beaurocrats of one political party are capable of managing my share of the burden better than members of another political party.

Ever notice how there are politicians who go to Washington for 6+ years with less than $200K in assets who come home or move on with over $1mm in assets?  Very few are there for you, most are there for their own gain.

[TheArtist]

We have bad health, high rates of drug abuse, high homelessness and hunger, high rates of child abuse, neglect and even death, crime, etc.  It seems to me that one common denominator is the low educational level of many of the people who create these statistics.  It also has to do with their ways of thinking, outlook and attitudes as well. Kind of a chicken and egg thing there. Even if offered a free education many people may not avail themselves of it.  I remember a study where they put out healthy food and junk food for lower class students and one at a homeless shelter. In both cases, when given a free choice, the people chose the junk food over the nutritious healthy food. It wasnt a matter of cost, they still made poor choices when both types of food were free.

I would say there is ample opportunity and choice for most, not all, people in our area.  Sure we can do more, but most people can choose to do what it takes to have a better life.  Whats stopping most is their life habits and thought processes.  

How do we reach out and change those things?

One thing is to have a top noch pre thru high school educational system that can help each child learn what they may not be learning at home. Every child should have some sort of PE/ fitness and nutrition class in every grade, period. Every student should do some sort of exercise every day at school, whether they choose between tai-chi, running, weight training, yoga, whatever, they should have one class a day thats physical exercise and its not an elective. Frankly the old "gym class" model was a crock of bull imo. One day you would play dodge ball, the next climb a rope, the next baseball, the next swim, sit around on your duff the next day, etc. you never really learned a pattern of behavior, a habit that you would use in your adult life.  Every day for half a year or a full year, you do one thing, swimm, jogg, weight training etc, plus learn about health and nutrition.  They learn a healthy habit, discipline, goal setting.  Any other "sports" would be an elective on top of that, just like they are now an elective on top of english and math.  

Second thing is to volunteer and mentor.

Third thing is for leaders of our state and different communities to ceaslessly champion health and well being, education, and volunteering.

[tim huntzinger]

Here is the OK ranking.

Imprimis, national health insurance is not the answer. Saying it is is like saying we need better boats made of sponges, or better pants made of cardboard.

I keep thinking that we need more doctors and medical professionals, to protect facilities against frivolous lawsuits, and do more to prevent illnesses from becoming disabling.

All I needed to know about healthcare I learned from Bono: 'The rich stay healthy, the sick stay poor.'

[cannon_fodder]

HT - good points.  Education is key to crime, poverty, and health issues.  However, you are also right in pointing out that in some cultures (notably many black and hispanic communities) getting an education is "selling out" and many will not take advantage of opportunities if presented.  

An excellent K-12 program would help all situations.  However, achieving that is difficult if the community is not interested.  Clearly, throwing money at the problem does not work as the per child cost of education is rising rapidly with few if any noticeable returns.

Tim - Availability of health care does not equate to good health.  Even though the majority of American's have health insurance that would cover preventative health care, the vast majority do not take advantage of it.  So stock as many doctors as you want into an area, it doesnt mean people will go - until they are sick... then we have poor health anyway.

[tim huntzinger]

I dunno, CF, market forces either work or they do not.  More health care pros in the community, more in the family, more education geared toward that end will result in people taking better care of themselves.

RE the OK stats, I wonder what part Native Americans' health issues play in the overall rankings (diabetes, alcoholism, depression).

[Conan71]

quote:Originally posted by tim huntzinger

I dunno, CF, market forces either work or they do not.  More health care pros in the community, more in the family, more education geared toward that end will result in people taking better care of themselves.

RE the OK stats, I wonder what part Native Americans' health issues play in the overall rankings (diabetes, alcoholism, depression).

A lot of our health problems are self-inflicted.  I know I tend to stay pretty healthy until I get busy and don't get enough rest or eat right for a few weeks, then I wind up with some sort of bug.  I don't excercize like I should and I eat crap food half the time and I'm full aware that increases my risk of circulatory diseases, diabetes, etc.

Some people have bad habits which are documented to lead to health problems.  If everyone excercized who is physically capable, it might cut health care expenditures 1/3 to 1/2, I don't think anyone knows for sure.  There again, over-aggressive excercize programs can lead to other health problems.  

They had nutritional education programs all the way back when I was in grade school 30 years ago.  I keep up on health trends and I have a wife that is a "food snob" and is always trying to make sure I eat right.[]  IOW- I know what is and isn't good for me, I like others, just don't make good health choices, either due to laziness or convenience issues.

Some people absolutely won't go to a doctor until that growth on their neck is the size of a baseball, or they ignore chronic abdominal pain until they pass blood.  More doctors won't change that if people are still reluctant to go.

My wife is presently doing an LPN to RN "bridge" program.  There is a reputed shortage of RN's, but yet hospitals seem perfectly happy stocking their nursing payroll with LPN's and nurse assistants who command a much lower pay scale.  As well, teaching resources seem to be limited as even students with high grades are having to wait in line to get into some higher ed medical programs.

I'd be willing to bet that eating habits and what is eaten in Hawaii is more pure meats, vegetables and fruits than our meat and processed starch diet here in the plains.  We also like huge portions here.