Status of Ohio Health Care Profiled in HHS Report

Status of Ohio Health Care Profiled in HHS Report

Average Family Health Premiums up 92% Since 2000

Top 2 Private Insurers Corner 58% of Health Care Market

by John Michael Spinelli

June 26, 2009

COLUMBUS, OHIO: In a report released Friday by the U.S. Department of Health and Human Resources profiling the status of health care for each state, a laundry list of why Ohio needs reform from the status quo was presented as another front in the now explosive, partisan debate taking place in Washington about whether private insurance companies remain at the center of health care delivery or whether a so-called public option, where government is in charge and can use its size and clout to negotiate better deals for its members, is allowed to compete, giving Americans another choice as they decide what's best and most affordable for them.

The HHS report, released under the stewardship of its leader, Kathleen Sebelius, former Governor of Kansas and daughter of former Democratic Ohio Gov. John Gilligan, reflects the public policy stance of President Obama, who says he is committed to working with Congress to pass comprehensive health reform this year in order to control rising health care costs, guarantee choice of doctor, and assure high-quality, affordable health care for all Americans.

"We know that we need health reform to ensure Americans get the high-quality, affordable care they need and deserve. Under the status quo, too many Americans can’t get the affordable care they need when they fall ill. But health reform must make health care more than just sick care," Sebelius said on the Web site HealthReform.gov.

Sebelius, who was chosen to lead HHS after former Sen. Tom Daschle, Obama's first choice, withdrew his name from consideration, says President Obama wants to work with Congress to "enact health care reform legislation that protects what works about health care and fixes what is broken." Ohioans know that inaction is not an option, it said, noting that "sky-rocketing health care costs are hurting families, forcing businesses to cut or drop health benefits, and straining state budgets." It's stark case for change is based on its belief that "millions are paying more for less...and families and businesses in Ohio deserve better."

So what's the profile HHS laid out for Ohio? Here it is in detail:

OHIOANS CAN’T AFFORD THE STATUS QUO

• Roughly 7.4 million people in Ohio get health insurance on the job, where family premiums average $12,689 about the annual earning of a full-time minimum wage job.
• Since 2000 alone, average family premiums have increased by 92 percent in Ohio.
• Household budgets are strained by high costs: 20 percent of middle-income Ohio families spend more than 10 percent of their income on health care.
• High costs block access to care: 12 percent of people in Ohio report not visiting a doctor due to high costs.
• Ohio businesses and families shoulder a hidden health tax of roughly $1,000 per year on premiums as a direct result of subsidizing the costs of the uninsured.6
  

AFFORDABLE HEALTH COVERAGE IS INCREASINGLY OUT OF REACH IN OHIO

• 11 percent of people in Ohio are uninsured, and 64 percent of them are in families with at least one full-time worker.
• The percent of Ohioans with employer coverage is declining: from 71 to 65 percent between 2000 and 2007.
• Much of the decline is among workers in small businesses. While small businesses make up 72 percent of Ohio businesses,9 only 47 percent of them offered health coverage benefits in 2006 -- down 5 percent since 2000.
• Choice of health insurance is limited in Ohio. WellPoint Inc. (BCBS) alone constitutes 41 percent of the health insurance market share in Ohio, with the top two insurance providers accounting for 58 percent.
• Choice is even more limited for people with pre-existing conditions. In Ohio, premiums can vary based on demographic factors and health status, and coverage can exclude pre-existing conditions or even be denied completely.
  

OHIOANS NEED HIGHER QUALITY, GREATER VALUE, AND MORE PREVENTATIVE CARE

The overall quality of care in Ohio is rated as “Average.”

Preventative measures that could keep Ohioans healthier and out of the hospital are deficient, leading to problems across the age spectrum:

• 19 percent of children in Ohio are obese.
• 21 percent of women over the age of 50 in Ohio have not received a mammogram in the past two years.
• 39 percent of men over the age of 50 in Ohio have never had a colorectal cancer screening.
• 72 percent of adults over the age of 65 in Ohio have received a flu vaccine in the past year.
  

For those of us over age 60, having access to affordable, quality health care is a top priority. With Ohio under the gun as Democrats and Republicans try to reach accommodation on a budget that is way out of balance, and that can only be brought back by either more harsh cuts, many of which will affect the poorest and least able to fend for themselves, or by raising taxes, a voodoo dance no elected political official wants to engage in. It's one thing to have a sick budget, it's another to have a sick population that seems boxed in by the rules of the road private insurance companies have put in place. Reform at the state and federal level is long overdue. But the final form of reform will be a prescription some will eagerly swallow while others will find unappetizing at best.

John Michael Spinelli is a Certified Economic Development Financing Professional, business and travel writer and former credentialed Ohio Statehouse political reporter. He is registered to lobby in Ohio and is the Director of Ohio Operations for Tubular Rail Inc. Spinelli on Assignment is syndicated by Newstex.com. SOA can be followed on Twitter @OhioNewsBureau and available for subscription to Kindle owners. To send a news tip or make comment, email ohionewsbureau@gmail.com

Emergency Room Docs Dwindling, OSU Study Warns

Emergency Room Docs Dwindling, OSU Study Warns

Shortage of General, ER Surgeons by 2010

OhioNewsBureau

with John Michael Spinelli

Columbus, Ohio: Results of a study by researchers at The Ohio State University warn that by as soon as 2010 there may not be enough surgeons in U.S. hospitals to treat the critically injured or chronically ill.

Study co-author Thomas E. Williams, clinical associate professor of surgery at The Ohio State University, says the number of available general surgeons, who often perform life-saving operations on patients in emergency rooms, will not keep up with public demand. A retired thoracic and cardiac surgeon, Williams, whose study projections were based on data from the US Census Bureau and the American Board of Surgery and included population statistics and projections, medial school graduation rates and information on the number of surgeons currently practicing, said that as the population continues to grow, there will be a shortage of 1,300 general surgeons in 2010. He warned that that shortage will worsen each decade, reaching a deficit of 6,000 by 2050.

"That means people will have to wait longer for emergency treatment and for elective general surgery," he said.

A big difference between selecting and training doctors here compared to other countries where the state pays for their medical human infrastructure, is that US students should expect to leave medical school with between $125,000 to $150,000 of debt. The overwhelming costs of obtaining a medical degree are a large deterrent for many young students, despite scholarships and financial aid, Thomas said to OSU research communicators.

“People may wait hours in an emergency room if there is a shortage of surgeons. But the problem is that if you’re not operated on within a few hours, your disease progresses and that can create more serious problems in other areas of the body. These are problems that you would not have had with prompt surgical attention.” [Thomas E. Williams of OSU]

General surgeons are called upon in emergency room to determine whether or not to operate on a patient. Increasingly, the medical professionals are choosing to specialize in other fields such as cardiac or orthopedic surgery; thereby creating the shortage of general surgeons that will directly impact emergency rooms around the country, which rely on general surgeons.

The shortage calculated by Williams and Ellison derived from the difference between the number of retiring surgeons and those entering the workforce. They compared this number to the expected need for general surgeons. Statistics show that 7.53 general surgeons are needed for every 100,000 people to keep the current level of care. Sadly, their study shows this number will not be met as early as 2010.

There are about 21,500 general surgeons practicing in the United States today. Each surgeon practices for an estimated 30 years and about 705 surgeons die or leave the workforce every year for personal reasons or retirement, their study showed.

Meanwhile, nearly 1,000 new surgeons enter the workforce each year. But of that number, only 850 will practice general surgery. After accounting for retiring surgeons, that means only 145 new general surgeons will enter the workforce. This is far less than is needed given the continuous rise in the population.

As doctors continue to specialize, contributing to an even larger shortage of general surgeons, Williams said it will cost $62.5 million per year ($750 million total) to train the additional 1,875 general surgeons needed by 2020.

Overcoming barriers to minting more doctors and medical schools to produce them are daunting. Williams said the "overwhelming costs of obtaining a medical degree are a large deterrent for many young students, despite scholarships and financial aid."

More problematic is that students required to train as residents are often paid about $45,000 while their professional cousins, lawyers, can land a cool $150,000 to $200,000 per year right out of law school.

Lawyers can work weekdays, with some evening and weekend work when needed, but medical interns can expect to work nights, weekends and uneven hours for up to seven years for considerably lesser pay.

Williams said what needs to be done is to make this profession more attractive through programs to help reduce costs and arranging the 80 hour work weeks to more manageable schedules. "Without these changes, we simply won’t keep up with the increasing demand,” he said.

The duo of Williams and his co-author, Christopher Ellison, professor and chair for the department of surgery at OSU, also co-authored a book with fellow Ohio State professor Bhagwan Satiani, entitled "The Coming Surgeon Shortage: Who will fix our hearts, your hip, and deliver our grandchildren?" OSU communication staff say the book is expected to be released late next year.

John Michael Spinelli is a former Ohio Statehouse government and political reporter and business columnist. To send a tip or story idea to this correspondent, send an email to ohionewsbureau@gmail.com