Interesting health facts

Many people seem to have lost their sense of reason this summer. Perhaps it's a side effect of climate change. Or a slow news cycle. Whatever it is, we have people fomenting at the mouths over the proposal to ensure that every resident in the U.S. has access to the health care they need, when they need it. I would hope that whatever conversations can be had around whether and what kind of health reform we are to have in this country, it is based around facts rather than fear and lies.

In response to a recent discussion (well, one person was discussing, the other was ranting), I thought I'd provide some facts about health and health care in the U.S. I randomly chose North Carolina to compare to Massachusetts, Vermont, and Wisconsin. Massachusetts was chosen because we have a mandatory health insurance law and provide support and subsidies not too dissimilar to the controversial "public option." Vermont has a small, rural population and a well-regarded system of integrated health care. Wisconsin has been on the forefront of social health and welfare experimentation for decades, particularly in extending health care benefits to children. Whatever health reform gets passed, it will likely incorporate different elements of the systems found in these states.

Below are comparative rankings derived from Kaiser State Health Facts website. The Kaiser Family Foundation is considered one of the most credible sources of comparative health information.

% non-elderly uninsured (in order of most to least insured):
Massachusetts: 1
Vermont: 36
Wisconsin: 7
North Carolina: 44

% reporting that they could not see a doctor because of cost (in order of highest to lowest access to care)
Massachusetts: 2
Vermont: 15
Wisconsin: 5
North Carolina: 45

% adults who visited a dentist or dental clinic within the past year (in order of highest to lowest dental visits)
Massachusetts: 2
Vermont: 8
Wisconsin: 16
North Carolina: 33

Infant mortality rate (in order of lowest to highest infant mortality rate)
Massachusetts: 2
Vermont: 6
Wisconsin: 19
North Carolina: 44

Stroke and other cerebrovascular disease deaths (in order of lowest to highest):
Massachusetts: 10
Vermont: 12
Wisconsin: 26
North Carolina: 46

Per capita health spending (in order of highest to lowest spending)
Massachusetts: 2
Vermont: 9
Wisconsin: 16
North Carolina: 30



So what have we learned here? The states that make the effort to provide access to health and medical care, as Massachusetts, Vermont, and Wisconsin do, have better outcomes. Indeed, on these randomly chosen measures of access, utilization, and health status, these three states consistently rank in the top 33-50 percentile. North Carolina, on the other hand, has comparatively less access, and also poorer health. This state consistently ranks in the bottom third. Interestingly, Vermont has a relatively low rate of health insurance, and yet still ranks higher than North Carolina on every other measure.

So access to health insurance matters, but it isn't the whole story. The structure of the health care system is equally important. That is a conversation that we have not yet had the opportunity to have.

As the per capita health expenditures shows us, we also see that ensuring good access requires that we spend a little money. As these measures of health status show us, it appears to be good money spent.