Our Health Policy Matters

What do South Carolina, Texas, Louisiana, and Mississippi have in common? They all find themselves among the worst states for your health.  And they all have governors who have already declared that they don’t want to expand Medicaid to uninsured adults in their states. South Carolina ranks 40 th , Texas is 41 st , Louisiana is 44 th , and Mississippi is 47 th in the 2012 Our Health Policy Matters rankings of the states. The worst state for your health this year is Oklahoma, which dropped from 47 th a year ago.  New Mexico came in just ahead of Oklahoma, and just below Nevada, Mississippi, and Arkansas.  Rounding out the bottom ten were Alabama, Louisiana, West Virginia, Texas, and Montana. Led by middle-of-the-pack Medicare and Medicaid community spending, West Virginia escaped the bottom of the rankings this year.  Its 43 rd place finish represents an improvement of seven places over last year’s worst-in-the-nation finish.  On the other hand, Texas had

If you want to live in the state where Medicare pays the most per capita for home-based care for elders, then Florida is the place for you.  On the other hand, if you prefer the state which does the best job of protecting the health of its children, then head to Vermont. But if you want to live in the best state for your overall health, then Connecticut is where you want to be. Connecticut is the new number one in the 2012 Our Health Policy Matters Best States for Your Health Rankings .  Last year’s runner-up switched places with last year’s winner, Massachusetts, dropping its northern neighbor into second. The OHPM rankings are a compilation of seven independent rankings and ratings of states.  The sources from which the final OHPM rankings are drawn are described below.  Connecticut made the top by scoring well across the board, finishing second in Medicaid spending on community services, third in the Healthy State rankings and in the percentage of people privatel

A Medicare exchange in which private plans compete with a public option?  A Medicaid program unshackled by federally determined program requirements and eligibility criteria? Now that Governor Romney has chosen Rep. Paul Ryan as his running mate, these new visions of Medicare and Medicaid will become part of the health policy debate in every state. They are both part of Vice-Presidential candidate Ryan’s now-famous Path to Prosperity proposal  published earlier this year. In his vision, Ryan attacks an “open-ended, blank-check” Medicare subsidy that in practical terms means a government that will pay providers what it costs to treat diseases even for the most expensive seniors.  In his own words:  “Medicare subsidizes coverage for seniors to ensure that coverage is affordable.  Affordability is a critical goal, but the subsidy structure of Medicare is fundamentally broken and drives costs in the wrong direction.  The open-ended, blank-check nature of the Medicare s

If 243 members of Congress knew that they were going to develop Alzheimer’s Disease or related dementia, would it change the way they make Medicaid and long term care policy? Or would they continue to deny the inevitable? When Congress convened in 2011, the average age of a House member was 57, and the average age of a senator was 62.   They were approaching the prime years for dementia. If you don’t already have Alzheimer’s Disease or related dementia by the time you turn 65, then your chances of developing it between the ages of 65 and 74 are greater than one in 20.  Your chances of developing it between the ages of 75 and 84 are almost one in 7.  And after that your chances of developing it are one in 4. At today’s prevalence rates, 28 members of Congress will develop dementia between the ages of 65 and 74, 91 between the ages of 75 and 84, and 124 later on. The only thing that will change this trajectory is if they die sooner of something else. If I were

In the next twenty years, more than 3 million people over the age of 65 will likely experience serious mental illness.  Are we prepared to treat them? The answer is no, according to a new Institute of Medicine report.  The report was released in July , and it contains some striking evidence of the challenges we face as we confront the growing behavioral health care needs of our aging population.  We don’t have nearly enough trained providers. And when states cut their existing state Medicaid programs or refuse to adopt the ACA Medicaid expansion, these decisions have devastating consequences for the providers we do have – and, of course, their patients.  Today, between 5.6 and 8 million adults over the age of 65 are believed to have mental illnesses.  These numbers could nearly double over the next twenty years.  There’s a reason that the range is so big.  We’ve given so little attention to this challenge in the past that we don’t even have an accurate count.