Maureen Hayden had a good column on the state of Indiana Health Care. She notes that the Healthy Indiana Plan, touted by Gov. Pence as an adequate alternative to Medicaid expansion under the Obamacare reforms, serves only 37,000 Hoosiers (with a waiting list of 55,000); leaving out 300,000 who would have been covered if Medicaid had expanded as expected.
When asked about uninsured Hoosiers:
Pence’s response was to say there was a “broad range of services” available to uninsured Hoosiers, from public clinics to hospital charity care.
“Let’s make sure there is a distinction in the language between health insurance and health care,” he said. “Every person in this state has the ability, if they are struggling with illness, to walk into an emergency room and receive care.”
In most cases, the emergency room is a wasteful place to initiate care. “A stitch in time saves nine” and all of that. I have collected hundreds, possibly thousands, of emergency room bills over the years; and they are expensive with people ill-equipped to pay them — they couldn’t afford them at the time of service, and often enough, the health condition that sent them to the ER renders them less able to work. The collection rate is well under 100% meaning that the rest of us subsidize these services in any event.
It would make much more sense to have a rational funding mechanism where we subsidize these health services explicitly and thereby allow delivery of the services in places outside the ER where better health outcomes can be had for less money. Instead, we have this ad hoc system where the subsidies are more hidden and the most expensive, least effective delivery mechanism is used.
Hayden’s column concludes:
Pence is correct: There is a safety net for the ill and uninsured. But it’s a tattered one.
. . .
“We do have access, but the health of Hoosiers is not good,” Kelso said, before listing a litany of ills that include Indiana’s high rate of diabetes, heart disease, obesity and infant mortality (which is related to lack of access to pre- and post-natal care.)The governor’s own health commissioner, Dr. William VanNess, recently noted that an infant born in Indiana has a higher rate of dying before its first birthday than almost anywhere else in the nation. Indiana now ranks 47th out of the 50 states in infant mortality.
. . .
“We’re down near the bottom. We’re right down there with Mississippi and Arkansas in the number of babies that are dying. Think about that.”
I guess I could insert a “pro-life” quip; but that would buy into the frame of that debate — when that debate is more properly seen as being about female sexuality.
Instead, Indiana’s hang up and resulting poor health probably has more to do with a deeply held fear that people might get something for nothing. Laziness is immoral; and economic well-being signifies moral rectitude. If we give people (who, by virtue of their poverty are demonstrably lazy) free healthcare, they will lack proper incentives to work. Or something like that. Consequently, we continue to embrace a system that is as inefficient as it is destructive to the health of Hoosiers.
Can’t tell you how much this pisses me off.
A redneck solution for a redneck state.
As soon as possible I will be taking my business elsewhere and I am not joking.
A redneck solution for a redneck state.
Jharp, man does this observation sum up the Hoosier Way. Good one!
Doug left out this nugget. From the article.
“The governor’s own health commissioner, Dr. William VanNess, recently noted that an infant born in Indiana has a higher rate of dying before its first birthday than almost anywhere else in the nation. Indiana now ranks 47th out of the 50 states in infant mortality.”
“We’re down near the bottom. We’re right down there with Mississippi and Arkansas in the number of babies that are dying. Think about that.”
Good thinking Governor Pence. Denying 300,000 Hoosiers access to health insurance and much needed prenatal care is a great idea. We clearly can’t afford to deliver healthy babies anymore.
Whoops. My dyslexia is acting up again. Doug did include that nugget.
To be fair, babies might be the biggest moochers of them all.
Population control?
Pence is flat-out wrong. EMTALA, the law which requires EDs to provide care, contains a level of severity. Appear with a chronic, non-emergency and you are out of luck. But if that little punk wants to stand behind the canard, he can attempt to do so.
I wonder what Pence’s law school GPA was?
Well, according to one regular here, Pence was a really sharp guy in law school. Of course, that same person thinks the vast majority of climate scientists have some sort of anti-business agenda or some such.
Oh, I can guess who this analyst is? Thank, Pila.
Two points: Pence’s comment as to alternative health care options sound a great deal as the queen saying when folks had no bread–“let them eat cake”.
The state program still lacks any provision for companies to have to offer “child only” health insurance. That is, if parents/guardians do not have coverage through a job or are retired and thus on Medicaid then there is no company that will sell health insurance for a minor child. Situation of having adopted a grandchild that is now 6 years old and no way to purchase health insurance for her.
Pence’s remarks are very similar to the ones Mitt Romney made during the 2012 presidential campaign. Pence does, as Romney did, reveal a profound ignorance of the difference between health care and emergency health interventions. Care from a local hospital’s emergency department is not adequate for those who have chronic diseases and conditions, which need ongoing treatment to be kept in control.
Well, if Mikey or his family gets sick, you can bet that they are not going to spend the evening in the ER. Healthcare will come to them, more likely than not, rather than they going to the health facility, at least for the short-run.