Louisiana finished dead last in a newly released report ranking states on health care.
The study, “2018’s Best & Worst States for Health Care,” was conducted by the consumer website WalletHub.
“Louisiana has the worst health care system in the country,” WalletHub analyst Jill Gonzalez told Watchdog.org. “It has the third highest share of adults reporting not seeing a doctor because of costs, at 18 percent. It also has only 16 dentists per capita, which is the lowest number in the U.S. The Medicaid acceptance rate among physicians in Louisiana is 54.2 percent, the third lowest in the country.”
WalletHub’s top states for health care are Vermont, which ranks first, followed by Massachusetts, New Hampshire, Minnesota, Hawaii, Rhode Island, Colorado, District of Columbia, Iowa, and Maryland.
With all 50 states and the District of Columbia included in the analysis, Louisiana placed 51st.
“Unfortunately, high costs and poor access to good quality health care lead to grim outcomes for the state’s residents,” Gonzalez said. “It has some of the highest infant, child and maternal mortality rates in the country, one of the lowest life expectancy rates at 75.82 years, and the lowest share of adults with no dental visit in the past year (43.23 percent).”
WalletHub compared the states and the District of Columbia across 40 metrics within three main categories: cost, accessibility and outcome. Costs include medical visits, monthly premiums, and out-of-pocket expense. Access includes quality of public hospital system, response and wait times for emergency services, a range of providers per capita, acceptance rates for Medicaid and Medicare, and shares of insured adults and children. The outcomes category includes mortality rates, share of readmission and discharges of hospital patients, life expectancy and disease rates among other factors.
WalletHub highlights data from the Centers for Disease Control (CDC), which indicates that 88 percent of Americans have a regular place where they can receive medical care. But the cost of care and level of quality vary widely by state. Costs are affected by the overall health of the population, more advanced medical equipment, and a general lack of awareness about treatment options.
The report also points to estimates from the Centers for Medicare and Medicaid, indicating that Americans, on average, spend more than $10,000 per year on personal health care, roughly 17.9 percent of the U.S. GDP.
“Higher costs don’t necessarily translate to better results,” Adam McCann, WalletHub financial writer, said.
Pointing to a Kaiser Family Foundation study, McCann said that despite higher costs, the U.S. lags behind several countries in several areas related to health care. Despite this, he adds, the U.S. has improved in providing more health care access for people who exhibit worse health, “and health care cost growth has slowed somewhat.”
Critics note that when discussing health care, the term “health system” is too vague. In America, unlike other countries, “health system” can refer to the Veterans’ Administration, Medicare, Medicaid, Social Security, and Indian Health Services. Health systems also often include third party payment schemes. Using the phrase “access to medical care” is more accurate, they argue.
Linda Gorman from the Independence Institute told Watchdog.org, “The measures in the CDC report are population health measures. Many of them really measure individual behavior, SES status, or demographics rather than how well a state’s medical services function.”
Gorman points to the category of “life-expectancy,” which is unrelated to medical care in that its calculation can be radically affected by high rates of accidents, suicides, and murders at younger ages.
“Conversely,” she notes, an industrialized country with good medical care is likely to have a higher “disease burden as people who would otherwise die from chronic diseases like diabetes, hepatitis, and various kinds of cancers end up living longer.”
Ranking states by percentage of insured adults and income does not correlate to an individual’s positive or negative health condition, she added.
“Lower-income people tend to be younger and are less likely to work in jobs offering benefits,” Gorman said. “Evidence showing that not having coverage increases mortality rates is slim.”
This article was first published by Watchdog.org.