Our Health Policy Matters

According to a recent report in Health Affairs , health spending in the United States is projected to rise by 5.8% per year over the next decade. source: CT OPM Rising health care costs are a problem that must be brought under control.  One approach is to do what Florida's doing.  It is forcing state employees into a single HMO, removing all competition from the market while praying that the HMO won't be motivated by making a profit.  Another is to look at what the State of Connecticut is doing. It is betting over $100 million that its employees and retirees will respond to a different kind of “individual mandate” from the one under fire in the Affordable Care Act.   Connecticut has decided to give financial incentives to employees and retirees to manage their health.   It will also penalize financially those who do not.   State workers overwhelmingly voted to accept the new deal earlier this month.   If the plan works, then it may signal a new path for every st

A recent story in Health News Florida broke the news that Blue Cross and Blue Shield of Florida (BCBSFL) has notified all of its participating mental health providers that their contracts are being terminated as of November. Those who wish to continue to see BCBSFL patients will have to sign a contract with a new provider partially owned by Blue Cross and Blue Shield.   Their payments will be cut between 25% and 55%. BCBSFL’s notice caused a justifiable uproar – one that may extend beyond the boundaries of the state.   Mental health advocates see the action as a violation of the federal Mental Health Parity Act, because only mental health providers have been singled out. Florida residents are also concerned.   BCBSFL has four million members, and insures over 7 million people in the state.   They all may lose access to providers as a result of this action.   But up to 80 million on Blue Cross Blue Shield plans outside of Florida will also be affected.   Blue Cross Blue Shie

In a recent column, I wrote about the importance of public health spending in reducing the death rate.   What other public policy strategies also lead to a healthier state? Chart shows positve healthy state rank relationship to health spending, negative to business tax climate.   There are quite a few.   I compared several other state rankings with the most recent state health rankings published earlier this year. These included health care spending per capita, per enrollee Medicaid spending, Medicaid spending for people with disabilities, Medicaid spending on children, and state mental health agency spending.   I also looked at rankings in per capita income, household income, the percentage of people with private health insurance, and business tax climate.   It turns out that a higher state ranking in eight of the nine areas is related to a higher state health ranking.   In only one area – business tax climate – did a higher ranking predict a lower state health ranking. L

It was hard to witness the embarrassing spectacle of politicians responding to the credit downgrade by circling their firing squad yet again. I’d like to see some grown-ups emerge from the mess.   But I’m not holding my breath. Sources: CBO, GIH, KFF, CDC, NAPH Our debt problem was caused by tax cuts that didn’t create jobs, wars for which we didn’t pay, and an unsustainable and under-regulated financial bubble that burst .   It wasn’t caused by entitlements. Despite this, politicians are pushing entitlement myths and reforms.   But in the unsteady hands of this unstable Congress, entitlement reform could result in a health and mental health care Armageddon that could blow us all back into the 19 th century – the stone age of modern medicine. The Social Security and Medicare Trust Funds still have surpluses.   They aren’t responsible for the debt.   In fact, Social Security Trust Funds hold U.S. debt, just like China. We can do two things about future Social Security and

If you are as grateful as I am that the nonstop coverage of debt ceilings and deficits is behind us for a while, and want to talk about something even Congress should be able to agree is worthwhile, then just repeat after me these two magic words. (No, not those two!) The words are "public" and "health."  There is a new article out entitled Evidence Links Increases in Public Health Spending to Declines in Preventable Deaths .   Source:  Mays and Smith, Health Affairs, 7/11 The article has been published online by Health Affairs , and is in the August 2011 edition of the print journal.   It was written by Glen Mays and Sharla Smith. Spending on public health has long been one of our government’s great success stories.   It keeps our water clean, our air free of pollution, our food pure, our children immunized, and our homes and neighborhoods free of lead, rats, and violence.   It also promotes our health.   I wrote in a previous column about what this means