Robert Pear writes in the NY Times about a new federal study that shows that there is a significant range in health care spending per capita among the 50 states.

Massachusetts led the way in per capita health spending at $6,700, while Utah was less than $4,000 per capita. As he writes,

The study, published on Monday in the Web edition of the journal Health Affairs, said that Massachusetts, Maine, New York, Alaska and Connecticut had the highest per capita spending on health care in 2004.

The lowest-spending states were Utah, Arizona, Idaho, New Mexico and Nevada. Per capita spending in Utah was 59 percent of that in Massachusetts. [ . . .]

Sara Rosenbaum, a professor of health law and policy at George Washington University, said, “The variations help explain why some states can achieve health care reform on their own, without a huge infusion of federal money, while others cannot.”

“In a low-spending state like New Mexico, you have less money in the health care system that can be recaptured and invested in coverage for the uninsured,” she said. “In a high-spending state like Massachusetts, the health care system has the resources to subsidize coverage of the uninsured.”

Read the full article . . .

The lack of leadership at the national level to provide health insurance to the over 45 million Americans that do not have it, has driven states like Maine, Massachussetts to create programs for the uninsured within their borders. As Kevin Sack writes in the New York Times, some cities are becoming local laboratories for health insurance innovation.

[...] Healthy San Francisco, is the first effort by a locality to guarantee care to all of its uninsured [82,000 resident], and it represents the latest attempt by state and local governments to patch a inadequate federal system.

It is financed mostly by the city, which is gambling that it can provide universal and sensibly managed care to the uninsured for about the amount being spent on their treatment now, often in emergency rooms.

After a two-month trial at two clinics in Chinatown, the program is scheduled to expand citywide to 20 more locations on Sept. 17.

Whether such a program might be replicated elsewhere is difficult to assess. In addition to its unique political culture, San Francisco, with a population of about 750,000, has the advantages of compact geography, a unified city-county government, an extensive network of public and community clinics and a relatively small number of uninsured adults. Virtually all the city’s children are covered by private insurance or government plans.

Read the full article . . .

Imagine that you have one month to create a proposal to address healthy care in Colorado, and if it’s a good proposal it could be presented to the State Legislature in November.

Well, there is no need to imagine, you can be busy putting your ideas to paper.

The Colorado Blue Ribbon Commission for Health Care Reform (’the Commission’) has just released a call for Health Reform Proposals due to the Commission by 5:00pm on Friday, April 6, 2007. Prospective proposers should submit, by mail or email, a ‘Notice of Intent to Submit a Proposal’ by 5:00 PM March 13, 2007.

The purpose of the Blue Ribbon Commission for Health Care Reform is to ’study and establish health care reform models to expand health care coverage and to decrease health care costs for Colorado residents. For any questions regarding proposal, contact Sarah Schulte, Technical Advisor to the Commission, at sarahschulte@mindspring.com.

And you thought no one would listen.

Former Oregon Gov. John Kitzhaber wants the Oregon Legislature to reform the state’s health care system.  As Sarah Skidmore writes,

Roughly one year ago, Kitzhaber created the Archimedes Movement to get public say on how to reform the health care system. The group, which included the input of about 40,000 citizens, health care leaders and others, decided that all Oregonians should have access to health care and the state could deliver it more effectively than the current system.

The Oregon Better Health Act is a product of that group’s thinking. The act, if passed, would take the federal and state money currently being spent on health care and try and use it more effectively.

If passed, it would trigger a request to the federal government to grant Oregon the congressional authority to control state and federal health care dollars. Oregon would then design a system to provide physical, mental and other health benefits for all of its residents. The act would also create a process that allows the public to have a say on how the health care system would work.

Learn more about the Oregon Better Health Act . . .

There doesn’t seem to be any commodity that people’s pay can keep up with these days. Add Health care to the list. Although the rate of increase has slip to less than double digits increases over the last few years, health costs have still almost doubled (82.2%) since since 2000. Workers wages increased a paltry 15%.

Anyway you count the numbers, the results ain’t pretty for workers. Read Will Shanley’s article in the Denver Post . . .

Health care costs in Colorado have jumped 82.2 percent since 2000, more than five times the earnings increase for workers.

For family health coverage, the average annual premium paid by workers and employers rose to $12,386 in 2006, up from $6,797 in 2000.

Meanwhile, worker wages statewide grew by 15 percent, or $3,947, to a median of $30,337 per year.

Those findings were reported Monday in the study “Premiums Versus Paychecks: A Growing Burden for Colorado’s Workers.” Families USA, a health care advocacy group based in New York, prepared the report.

Medicare and Medicaid programs paid for more than half of all patient days at Colorado hospitals in 2005, fresh evidence that taxpayers are increasingly picking up the tab for health care at hospitals.

Data released by the Colorado Health and Hospital Association show Medicare and Medicaid combined to pay for 52 percent of patient hospital days in Colorado - the highest percentage ever reported for the state by the association.

Medicare, a federal program that covers people over age 65, paid for 34.2 percent of patient days statewide last year. Medicaid, a program for the poor that is equally funded by the state and federal taxpayers, picked up the tab for 17.8 percent of patient days, the report showed.

The balance of patient days are paid by private insurance, individual payments and other forms of payment such as workers’ compensation.

The government programs, especially Medicaid, do not fully cover the costs for hospital stays. As a result, hospitals are forced to shift the financial burden to private-paying patients and employers through higher insurance premiums, said Stuart Guterman, director of the Medicare’s Future program at the Commonwealth Fund, a Washington, D.C., foundation.

There are an estimated 46 million uninsured Americans. That includes about 767,000 people in Colorado, or 17 percent of the state population, according to the U.S. Census Bureau.

Read the full article in the Denver Post . . .

On June 2, Governor Owens signed Senate Bill 208, which “creates the blue ribbon commission for health care reform (commission) for the purpose of studying and establishing health care reform models to expand health care coverage and to decrease health care costs for Colorado residents.”

The commission is an acknowledgement that health care has reached a critical jucture in the state, and statewide policy reform might be an appropriate response. Colorado joins a number of states (Massachusetts, Maine, Illinois) and working on health care absent action at the federal level.

As with any ‘blue ribbon commission” there is no guarantee that the commission will fully explore all the issues relating to health careor that any recommended reforms will work or even be acted on by state legislators. However, the commission is an opportunity to engage residents, providers, and the medical commuinty how to increase access to and reduce the costs of health care in Colorado - an approach the state has not taken before.

First is was the Brits, now its those people with the funny accents up in the Great White North that are healthier than we Americans.

The way things are going, I’ve put money on the table that Cuba will be the next comparison and they will also be healthier that we are (would that be three strikes against the U.S. health care system?)

Cambridge Health Alliance (CHA) physicians, who teach at Harvard Medical School (HMS), authored a study in the July, 2006 issue of the American Journal of Public Health. Their news release states, “The study finds that U.S. residents are less healthy than Canadians, and despite spending nearly twice as much per capita for health care, U.S. residents have more problems getting care and experience more unmet health needs.”

The authors found that U.S. residents were less healthy than Canadians.Canadians had better access to most types of medical care (with the single exception of pap smears). Race and income disparities, although present in both countries, were larger in the U.S. Non-whites were more likely than whites to have an unmet health need in the U.S.

In the U.S., cost was the largest barrier to care. More than seven times as many U.S. residents reported going without needed care due to cost as Canadians (7.0% of U.S. respondents vs. 0.8% of Canadians). Uninsured U.S. residents were particularly vulnerable; 30.4% reported having an unmet health need due to cost.

A copy of the study is available at: http://www.pnhp.org/canadastudy/

Hot off the presses is a study in the Journal of the American Medical Association, which compares the health of residents of the United States and the United Kingdom.

One of the key findings in the comparison is the differences between the two countries. The United States spends $5274 per person, per year, on health care and the United Kingdom spends $2164

The study made sure to have 'apple to apple' comparisons given the different demographics in the two counties, so the comparison is between 45-55 year old non-Hispanic white men and women.

The findings are brutal. By basically every standard, Americans are sicker than the Brits. Diabetes, for instance is roughly double in the US than it is in the UK. The rates of other common ailments - hypertension, heart disease, heart attacks, stroke, lung disease and cancer - are also all higher in the United States. And oftern a lot higher, despite the fact that the Brits smoke about the same amount and drink twice as much as Americans. So much for the best health system money can buy.

See the full article in the JAMA . . .

Voters said "no" twice to a proposal to create and fund a health district in La Plata County.

The district was defeated by 6,040 votes (53 percent) to 5,290 votes (47 percent), while the tax levy was defeated by 6,869 votes (60 percent) to 4,538 votes (40 percent). The district would have been funded by a 1.7 mill tax levy, which would have raised about $4.2 million in its first year. A seven-member board, including two members from each of three districts and one at-large member, would have overseen the use of the district's funds.

The proponents' service plan would have focused money on primary and mental-health care. Funds would have gone to Valley-Wide Health Systems, the San Juan Basin Health Department, the Southwest Colorado Mental Health Center and others.

The 11,539 votes represent about 43 percent of the ballots mailed.

Read the full article in the Durango Herald . . .