Our Health Policy Matters

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 answer may boil down to two word

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 cut decades from life

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 created by combining

Nearly 2.1 million veterans received mental health care from the Veterans Administration between 2006 and 2010.   According to a Government Accountability Office report released in October , 1.2 million veterans received mental health treatment in 2010 alone. Almost 30% of the 7.2 million veterans who received treatment from the VA received mental health treatment.  So did 38% of Iraq and Afghanistan (“OEF/OIF”) veterans.  Many more probably needed it.  The GAO report shows how pervasive mental illness is among veterans, and how co-occurring mental illnesses overwhelm both veterans and their service delivery system. Younger veterans and reservists are especially affected. We now have over 22 million living American veterans, but only 4 million served during World War II or the Korean War.  Seven million served during the Vietnam War, and almost 6 million are OEF/OIF veterans.  OEF/OIF veterans accounted for 12% of all those receiving VA mental health services in

Obesity is a disease, just like cancer, heart disease, mental illness, and addiction.  That’s the message of experts at a recent  Future of Medicine summit on the subject. And there are missing pieces in the way states with some of the largest concentrations of obese residents, like Florida, Connecticut, Texas, California, New York, and New Jersey, approach the epidemic. As recently as 25 years ago, obesity was uncommon in America .  Most states didn’t even collect data on it, and not a single state reported obesity in more than 15% of its population.  Connecticut and Florida both reported rates under 10%. The CDC map at that link shows what has happened since.  Every state in the country quickly grew bigger.  By 2010, in 12 states, including Connecticut, between 20% and 25% of the population was obese.  In 24 states, including Florida, between 25% and 30% of the population was obese.  In the remaining 12 states, including Texas, over 30% of the population was ob