Red State Health Care

There is a sign inside the emergency room at the hospital nearest my house, "If you cannot afford to pay, we will stabilize you and send you to another facility."  I interpret this to mean if you can't pay, the hospital will do the minimum necessary to avoid a lawsuit, then shove you out the door and leave you in the back of an ambulance.  It is a for profit hospital, of course.  Immediately upon entry, this hospital tells you that payment for services is equal to the lives of their patients. 

During the health care reform debate this year in Congress, I heard all manner of arguments in favor of a free market system of health care coming from Republicans.  It is an ideological argument that says a free market health care system produces the best health care at the lowest cost.  Death panels, socialized medicine, government control of health care decisions were just a few of the scare tactics that Republicans used to try to block health care reform.  The G.O.P. pushback against a Democratic bill was fierce; nearly all Republicans voted no. 

Republican rhetoric caused me to wonder, what is so good about the current system that convinced Republicans to vote no?  I researched health care in states represented by Republicans in Congress and dominated by the G.O.P. in state government, the so-called Red States, and was struck the low level of medical care, general health of those populations and the high cost associated with that care.

For instance, Mississippi ranks 1st in heart disease among it's population, 3rd in highest number of uninsured as a percent of population, an infant death rate over 50% above the national average, ranks 50th in number of doctors per capita and citizens have a life expectancy rate over four years less than the national average.  Mississippi ranks 1st in the nation in the percentage of people below the poverty line (21.2%), but 48th lowest in Medicaid per capita spending ($8,711).  I doubt you will hear Republican Governor Haley Barbour boasting of those statistics.

Texas ranks 1st in percentage of highest uninsured, but 40th in number of doctors per capita (2.15 per 1,000 people) and 35th in Medicaid spending.  Oklahoma ranks 2nd highest of all states in heart disease, 6th highest in number of uninsured, the life expectancy of it's population is nearly three years below the national average and ranks 50th in Medicaid spending..  Alabama has the 3nd highest rate of heart disease, well above the average in cancer deaths, an infant mortality rate 33% higher than the national average, ranks 43rd in the number of doctors per capita, and ranks last (51 out of 51 including D.C) in Medicaid per capita spending. 

Whether it's South Carolina ranking 11th in most uninsured, above average cancer, heart disease, infant mortality rates and lower life expectancy, or statistics from other red states such as Georgia, Tennessee, Arkansas, Louisiana, red states, especially from the south, have negative health statistics compared to national averages. 

I've not heard Senate Republican Minority Leader Mitch McConnell of Kentucky talk about his state having the highest percentage of cancer deaths in the country, nor that Kentucky ranks 2nd in the nation in percentage of people below the poverty line, but 46th in Medicaid per capita spending.  Yet, McConnell and many of his Republican colleagues complain that universal coverage would not only reduce the quality of care, but make health care more expensive. 

Statistics, however, show exactly the opposite to be true.  Massachusetts (the only state with a universal health care system) spends an average of 13% of their per capita income on health care, while Kentucky spends an average of 17% (2007 numbers); Alabama spends 19.8%, Oklahoma spends 14.3%. 

To be fair, western Red States fare better in health care statistics, but spend far more in Medicaid dollars to produce them.  Alaska, for example, has outstanding rankings in nearly every health category, but ranks 6th highest in Medicaid spending.  Idaho ranks 11th; Kansas 19th. It is disingenuous for Republican senators in those states to espouse an argument in favor of free market health care when their their states accept higher than average Medicaid payments. 

Republican defense of a free market system of health care is a fraudulent argument and shows a disconnect between Republican senators and the constituents they represent.  The G.O.P. is protecting the business interests of health care at the expense of the citizens they represent.  Ideology stops at the front door of the hospital.  People are the greatest natural resource and we should do everything possible to care for our population.   

To the hospital near my home that refuses to treat patients who cannot afford to pay, I ask why do you use one of Christ's apostles as your name?  You have Medicaid dollars available to you for low income patients and your development department is working full time to garner grants to pay costs.  It is indefensible that you would refuse to care for the poor.

To the Republican senators who voted no to health care reform, shame on you.  To vote no while you, yourselves,  enjoy the superior benefits of a Congressional health plan paid for by tax payers is indefensible.

And, that's a view from Missouri.

Note:  The statistics in this post were obtained from the U.S. Census, the Social Security Administration, Virginia Commonwealth University, StateHealthFacts.org, StateMaster.com  and the Gallup-Healthways Well Being Index 

















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Israeli-Palestinian Peace Negotiations

Charles Krauthammer's excellent article in today's Washington Post, Your move, Mr. Abbas, questions the sincerity of Abbas in the current round of Israeli-Palestinian peace talks.  What Krauthammer leaves out is this:  Abbas doesn't have enough political power to enforce an agreement, if one can be reached. Frankly, I think the time may have passed when any agreement is possible. Hamas and Hezbollah are stronger (thank you George Bush for invading Iraq and taking away Iran's primary enemy), Iran is on the threshold of being a nuclear power, the Saudis and Syrians seem to be sitting on the sidelines, and any lasting peace lies beyond what Palestinian and Israeli negotiations can produce. No one wants to give Hamas and Hezbollah legitimacy by giving them seats at the negotiating table, but facts on the ground make them legitimate power brokers. Unless Hamas and Hezbollah are brought into the negotiations, along with the nations who support them, no lasting peace is possible. George Mitchell and the Obama administration have done a great job of diplomacy in getting Netanyahu and Abbas to the table.  They should take the next step and incorporate side talks with Hamas, Hezbollah and Syria with the goal of establishing a regional solution to the Israeli-Palestinian conflict.  That's a view from Missouri.