State of the state's health is lousy -- it's time to act
The lipstick on the proverbial pig is that Southern states, including Georgia, have shown statistical improvements in more public health categories than the ones in which they got worse.
But in the Commonwealth Fund's annual Scorecard on State Health System Performance, Georgia dropped a notch, from an already abysmal 45th down to 46th. We're now officially in the bottom five in terms of public health.
The areas of improvement included more young adults receiving all of seven recommended vaccines, fewer adults smoking, and more home health patients showing progress in mobility. Georgia also had nominally fewer adults without health care coverage, but the increase was not nearly significant enough to move the state up from the basement in that category: Georgia's overall uninsured adult rate of 22 percent still leaves it in the bottom 10.
That's all the makeup for Miss Piggy on this issue. The Commonwealth Fund scorecard's 42 separate measures also include indicators such as lack of home prevention and treatment information, low-income adults without a regular source of health care, lack of regular (or any) dental care, and high-risk nursing home patients with pressure sores. In most or all of those categories, the low-ranking states performed abysmally.
What's especially infuriating about this human misery index is that so many people in Georgia and elsewhere are being sacrificed on no worthier an altar than politics. None of the bottom-ranking states is among the 30 that opted to expand Medicaid coverage, leaving hundreds of thousands of working poor to fall through the "coverage gap." They earn too much to qualify for Medicaid and not enough for subsidies to buy coverage through the Affordable Care Act (Obamacare). That accounts, according to Sara Collins, Commonwealth Fund vice president for health care coverage and access, to more than 300,000 uninsured Georgians. "That is one of the [nation's] highest uninsured rates in that income group," she said.
Commonwealth President David Blumenthal tiptoed gingerly around the fact that the first year in which more states got better than got worse in most of the 42 health indexes coincided with the first full year of ACA coverage.
"It is an unusual finding," he said. "I can't with scientific precision attribute it to the Affordable Care Act but I find it suspicious as an empirical event."
The most compelling consideration at this point is not Red State political resistance to ACA, but the fact that for the most part our leaders have demonstrated no urgency in coming up with something better, something different something.
If Medicaid expansion is still a line-in-the-dirt deal breaker, there's more than enough medical and economic expertise in Georgia to find another way. The coming legislative session would be a good time to get it done. The health needs of Georgians have been put on political hold more than long enough.
This story was originally published December 13, 2015 at 12:00 AM with the headline "State of the state's health is lousy -- it's time to act."