Our Health Policy Matters

Last week, I shared four of the top policy stories of the year that told us something about how health policy has been trending over the past decade or more.  This week, I’m offering four more to close out the year that tell us a little about where health policy is going in the future. 4.  Connecticut Employees Choose Health .  Back in the early days of managed care, when HMOs were not yet a four-letter word and they emphasized wellness as much as health care cost containment, they proved to be popular with members.  In August, the State of Connecticut revived the concept, giving its employees the choice of a lower cost health insurance plan that emphasized wellness or their traditional comprehensive plan.  It expected 50% to choose the new wellness plan.  But the state got a big surprise.  When the dust settled in October, 97% had opted for the wellness plan.  This will cost the state much more in the first year, but will also produce more ...

Last week, I shared four of the top policy stories of the year that told us something about how health policy has been trending over the past decade or more.  This week, I’m offering four more to close out the year that tell us a little about where health policy is going in the future. 4.  Connecticut Employees Choose Health .  Back in the early days of managed care, when HMOs were not yet a four-letter word and they emphasized wellness as much as health care cost containment, they proved to be popular with members.  In August, the State of Connecticut revived the concept, giving its employees the choice of a lower cost health insurance plan that emphasized wellness or their traditional comprehensive plan.  It expected 50% to choose the new wellness plan.  But the state got a big surprise.  When the dust settled in October, 97% had opted for the wellness plan.  This will cost the state much more in the first year, but will also produce more ...

Public policy attacks on public health and mental health, intrusions in doctor/patient privacy, the continuing fight over the Affordable Care Act, and our collective loss of faith in private health insurance were among the top health policy story lines of 2011. This year, eight stories make my short list.  Not all of these stories made big headlines during the year.  But they have had, or will have, an outsized impact on our lives. I’ll begin the countdown this week with four that capture and continue some of the major trends of the recent past.   Next week, I’ll offer four more that hint at where health policy may go in the future. 8.  The Shooting of a Congresswoman .  In January, the first big health policy story of the year was about violence and mental illness – the horrible wounding of a member of Congress, and the murder of several people around her.  As the media struggled to make sense of this, it raised once again the relation...

Public policy attacks on public health and mental health, intrusions in doctor/patient privacy, the continuing fight over the Affordable Care Act, and our collective loss of faith in private health insurance were among the top health policy story lines of 2011. This year, eight stories make my short list.  Not all of these stories made big headlines during the year.  But they have had, or will have, an outsized impact on our lives. I’ll begin the countdown this week with four that capture and continue some of the major trends of the recent past.   Next week, I’ll offer four more that hint at where health policy may go in the future. 8.  The Shooting of a Congresswoman .  In January, the first big health policy story of the year was about violence and mental illness – the horrible wounding of a member of Congress, and the murder of several people around her.  As the media struggled to make sense of this, it raised once again the relation...

Except for summertime humidity, the Florida and Connecticut “climates” don’t have a lot in common.  For example, Connecticut has one of the best climates for health and health care, while Florida’s is in the bottom half.  On the other hand, Florida has one of the best business tax climates, while Connecticut’s is near the rear. Their political climates are also polar opposites.  Florida’s governor is a Republican, and its Legislature is overwhelmingly Republican.  Connecticut’s governor is a Democrat, and its legislature is overwhelmingly Democratic. And the difference in their policy climates is reflected in the way they handled their 2011 budget crises.  Connecticut raised taxes and cut spending, while Florida just cut spending.  As a result, Connecticut’s budget now balanced.  Florida, meanwhile, extended its crisis by another year.  And its Governor has just proposed cutting $2 billion from health services alone in his proposed...

Except for summertime humidity, the Florida and Connecticut “climates” don’t have a lot in common.  For example, Connecticut has one of the best climates for health and health care, while Florida’s is in the bottom half.  On the other hand, Florida has one of the best business tax climates, while Connecticut’s is near the rear. Their political climates are also polar opposites.  Florida’s governor is a Republican, and its Legislature is overwhelmingly Republican.  Connecticut’s governor is a Democrat, and its legislature is overwhelmingly Democratic. And the difference in their policy climates is reflected in the way they handled their 2011 budget crises.  Connecticut raised taxes and cut spending, while Florida just cut spending.  As a result, Connecticut’s budget now balanced.  Florida, meanwhile, extended its crisis by another year.  And its Governor has just proposed cutting $2 billion from health services alone in his proposed...

If there were an award given for the worst health policy exaggeration of 2011, it might well go to Newt Gingrich, Mitt Romney, Rick Perry, and a chorus of others who call the Affordable Care Act “a government takeover of health care.” They make this charge to capture votes from a constituency that fears what life would be like if we had “socialized medicine.”  The problem with the rhetoric is this.  It isn't true.  If you look at who pays the bill, the United States already has socialized medicine. We just get less for our money than practically anyone else in the world. According new data from the Organisation for Economic Cooperation and Development (OECD) , no other country spends close to what our government alone does on health care.  Right now, the total government share of our annual per capita health care bill is around $6,000, or over 70% of the total .  Norway is next most expensive, but its total per capita bill is $5,352.  T...

If there were an award given for the worst health policy exaggeration of 2011, it might well go to Newt Gingrich, Mitt Romney, Rick Perry, and a chorus of others who call the Affordable Care Act “a government takeover of health care.” They make this charge to capture votes from a constituency that fears what life would be like if we had “socialized medicine.”  The problem with the rhetoric is this.  It isn't true.  If you look at who pays the bill, the United States already has socialized medicine. We just get less for our money than practically anyone else in the world. According new data from the Organisation for Economic Cooperation and Development (OECD) , no other country spends close to what our government alone does on health care.  Right now, the total government share of our annual per capita health care bill is around $6,000, or over 70% of the total .  Norway is next most expensive, but its total per capita bill is $5,352.  T...

It costs an average of $6,000 per person per year in federal, state, and local taxes to cover the government’s share of our national health care bill. The three levels of government pay about 71%, or roughly $1.8 trillion, of our nation’s annual health expenditures.  It is no wonder that most rational people want policymakers to do more to bring these costs under control. Policy leaders talk all the time about controlling health care expenditures.   This would help. But if we actually want to reduce costs significantly, we have to invest in prevention and public health.  This is a position I’ve pushed in the past.  All it takes to understand why is to recognize that prevention and public health have been responsible for half of our increased life expectancy during the past century while absorbing less than 5% of our overall health spending. This is old health policy news.  So why aren’t policymakers doing more in prevention? The ans...

It costs an average of $6,000 per person per year in federal, state, and local taxes to cover the government’s share of our national health care bill. The three levels of government pay about 71%, or roughly $1.8 trillion, of our nation’s annual health expenditures.  It is no wonder that most rational people want policymakers to do more to bring these costs under control. Policy leaders talk all the time about controlling health care expenditures.   This would help. But if we actually want to reduce costs significantly, we have to invest in prevention and public health.  This is a position I’ve pushed in the past.  All it takes to understand why is to recognize that prevention and public health have been responsible for half of our increased life expectancy during the past century while absorbing less than 5% of our overall health spending. This is old health policy news.  So why aren’t policymakers doing more in prevention? The ans...

Some states do a much worse job than others of keeping their residents healthy and providing for high-quality, affordable health care when their residents need it.  People usually live shorter, less healthy lives in these states than they might if they lived elsewhere. In my last column, I described a new States for Your Health ranking, and examined the states that finished near the top. This week, I want to look first at why Florida, ranked first in one of the seven indicators – per capita Medicare spending on non-institution-based services – only finished 30 th overall. Florida’s doesn’t invest enough in public health and prevention.  It is 36 th among the states in the 2011 Kids Count rankings, and 37 th in the 2011 Healthy State rankings.  Children in poor environments for their health are more likely to develop both physical and mental illnesses as they age.  Obesity, cancers, heart diseases, and mental illnesses are all expensive, and can cu...

Some states do a much worse job than others of keeping their residents healthy and providing for high-quality, affordable health care when their residents need it.  People usually live shorter, less healthy lives in these states than they might if they lived elsewhere. In my last column, I described a new States for Your Health ranking, and examined the states that finished near the top. This week, I want to look first at why Florida, ranked first in one of the seven indicators – per capita Medicare spending on non-institution-based services – only finished 30 th overall. Florida’s doesn’t invest enough in public health and prevention.  It is 36 th among the states in the 2011 Kids Count rankings, and 37 th in the 2011 Healthy State rankings.  Children in poor environments for their health are more likely to develop both physical and mental illnesses as they age.  Obesity, cancers, heart diseases, and mental illnesses are all expensive, and can cu...

When the Supreme Court reviews the constitutionality of the Affordable Care Act next year, it will do so against the backdrop of both a national sentiment for government to do more in the area of health and significant inequalities in access to health and health care based solely on the states in which people live.   A new poll released last week by the Robert Wood Johnson Foundation and the Harvard School of Public Health found that 52% of Americans want government to put more resources into health.   Only 41% gave high grades to our health care system, and only 33% gave our public health system high grades. We would all like a more effective health and health care system.  But a better national delivery system would make a much bigger difference in some states than in others. This week, Our Health Policy Matters unveils a new ranking of the states that reflects which states invest most effectively in our health and health care.  It was cr...