Showing posts with label uninsured. Show all posts
Showing posts with label uninsured. Show all posts

Wednesday, August 29, 2007

Poverty Rate Falls, but More Are Uninsured - Texas has highest rate of uninsured

By ABBY GOODNOUGH - The New York Times - August 28, 2007
The nation’s poverty rate fell in 2006 for the first time this decade, the Census Bureau reported today, even as the percentage of Americans without health insurance coverage hit a record high.

The results were not consistent across racial or age groups. For Hispanics, the poverty rate fell by 1.2 percentage points to 20.6 percent, while for whites, blacks and Asians, it remained statistically unchanged.

For elderly people, the poverty rate was among the lowest since 1959, when the government began collecting such data.

Median household income rose slightly for the second consecutive year, by seven-tenths of a percent, but the only statistically significant increase was in white households. It was the first real increase for white households since 1999.

Overall, the nation’s median household income rose to $48,201 in 2006, from $47,845 in 2005. It was the second consecutive year in which income rose slightly faster than inflation, after six years of decline.

“Even though overall it has not recovered to its 1999 pre-recessionary peak,” said David Johnson, chief of the housing and household economic statistics division for the Census Bureau, “the gap is narrowing.”

The slight improvements in household income and the poverty rate came even as the nation’s housing market started its steep decline and hurt employment in some states. But overall, it was a year of slow improvement in the job market and declining inflation.

The West was the only region of the country to experience a drop in the number and percentage of people in poverty. The South continued to have the highest poverty rate, at 13.8 percent, compared with 12.3 percent nationally, and the lowest median household income, $43,884.

Among large cities, Plano, Tex., had the highest median household income in 2006, while Cleveland, Miami, Buffalo and Detroit had the lowest. Among smaller cities, Youngstown, Ohio, and Syracuse had among the lowest incomes.

Census officials attributed the rise in uninsured Americans to 47 million from 44.8 million in 2005 mostly to Americans losing employer-provided or privately purchased health insurance. The percentage of people who received health benefits through an employer declined to 59.7 percent in 2006 from 60.2 percent in 2005.

The percentage of people with government-provided health insurance also dropped, to 27 percent from 27.3 percent.

The number of uninsured children increased to 8.7 million, or 11.7 percent, in 2006, from 8 million, or 10.9 percent, in 2006.

Texas had the highest percentage of uninsured residents in 2006 with 24.1 percent, while Minnesota had the lowest at 8.5 percent.

Mr. Johnson warned that even as median household incomes climbed slightly last year, both men and women brought home less pay for the third consecutive year. The household income growth was a reflection of more family members taking jobs to make ends meet, he said, and of some people earning more from sources other than wages, like investments.

Just over half of household income was concentrated in the fifth of the population with top income 2006, about the same as in 2005. Households in the lowest income quintile, on the other hand, accounted for only 3.4 percent of the nation’s household income.
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OPINION = EDITORIAL;
A Sobering Census Report: Bleak Findings on Health Insurance
New York Times - Aug. 29, 2007
The Census Bureau’s report on the state of American health insurance was as disturbing as its statistics on poverty and income. The bureau reported a large increase in the number of Americans who lack health insurance, data that ought to send an unmistakable message to Washington: vigorous action is needed to reverse this alarming and intractable trend.

The number of uninsured Americans has been rising inexorably over the past six years as soaring health care costs have driven up premiums, employers have scaled back or eliminated health benefits and hard-pressed families have found themselves unable to purchase insurance at a reasonable price. Last year, the number of uninsured Americans increased by a daunting 2.2 million, from 44.8 million in 2005 to 47.0 million in 2006. That scotched any hope that the faltering economic recovery would help alleviate the problem.

The main reason for the upsurge in uninsured Americans is that employment-based coverage continued to deteriorate. Indeed, the number of full-time workers without health insurance rose from 20.8 million in 2005 to 22.0 million in 2006, presumably because either the employers or the workers or both found it too costly.

Sadly, the one area where the nation had made progress — reducing the number of uninsured children — took a turn for the worse. The number of uninsured children under 18 dropped steadily and significantly from 1999 to 2004, thanks largely to an expansion in coverage of low-income children under two programs operated jointly by the states and the federal government, Medicaid and the State Children’s Health Insurance Program. Then last year the number of uninsured children jumped more than 600,000 to reach 8.6 million. The main reason, advocacy groups say, is that access and funding for the low-income programs became tighter while employer coverage for dependents eroded.

The challenge to the White House and Congress seems clear. The upward trend in the number of uninsured needs to be reversed because many studies have shown that people who lack health insurance tend to forgo needed care until they become much sicker and go to expensive emergency rooms for treatment. That harms their health and drives up everyone’s health care costs.

The most immediate need is to reauthorize and expand the expiring State Children’s Health Insurance Program. It has already brought health coverage to millions of young Americans. It should be reinvigorated to bring coverage to many millions more.

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Thursday, June 14, 2007

Studies say Texas lags in health care access

With high number of uninsured, state ranks 49th in one study
By JASON ROBERSON and ANGELA SHAH - The Dallas Morning News - Thursday, June 14, 2007
To many people, Texas has a strong reputation for quality health care.

Retirees who move to the state cite good hospitals as a key attraction. Dallas' Baylor University Medical Center and UT Southwestern Medical Center are renowned for churning out top-notch doctors. The University of Texas M.D. Anderson Cancer Center in Houston attracts patients from around the world.

But among the 50 states, Texas' health care system ranges from average to poor,
according to two reports released this week.


Industry experts say
the low rankings are explained largely by the widening gap between Texans who have health insurance and those who don't.

The large immigrant population and a high number of small businesses that don't offer health benefits to employees make Texas highest in the nation in the percentage of uninsured residents.


That helped rank Texas 49th out of 50 states and the District of Columbia for the overall performance of its health care system, in a study by the Commonwealth Fund, a nonprofit health care advocacy group. The study measured access to health care, quality of health care, avoidable hospital costs and deaths per 100,000 residents.

"We have too much pride in this state, and too much good economy, for us to sit back and tolerate this kind of rating," said Ladon W. Homer, immediate past president of the Texas Medical Association.

If Texas improved to the level of Hawaii, the best-performing state in the Commonwealth study, 2.7 million adults and 900,000 children would be insured, and the state would save $250.3 million a year, the study's researchers concluded.

A study released Monday by the U.S. Department of Health and Human Services pegged the state as average for health care quality, based on 129 indicators.The department began publishing the annual study in 2005 as a way to help state health leaders better recognize their strengths and weaknesses in providing quality care.

"Texas on overall quality is about average," said Ed Kelley, supervisor of the department's study.
"There are some things Texas is doing well and challenges that can be improved."

For example, the study found that Texas scored strongly for early colorectal cancer diagnoses and having a low percentage of nursing home residents who are depressed or anxious but poorly in areas such as full vaccination of children and avoidable hospitalizations for diabetes.

In both studies, Midwestern and Northeastern states such as Wisconsin, Minnesota, New Hampshire, Vermont and Maine performed the best. Those states have higher percentages of residents with health insurance and don't have the same impact from immigration as Texas does.

Many uninsured

In a state with 23.5 million people, more than 5.5 million – including 1.4 million children – lack health insurance,
according to the Texas Medical Association. Texas'
uninsured rates are about 1.5 times the national average.


Texas stands out for the ethnic makeup of its uninsured,
said Anil Kumar, an economist with the Federal Reserve Bank of Dallas.

Hispanics make up a third of the state's population – much larger than the 13 percent for the U.S. as a whole. More than half of the uninsured in Texas are Hispanic, compared with 25 percent for the nation.


Many Hispanics, particularly laborers, work at small businesses, said Roger C. Rocha Jr., state director of the League of United Latin American Citizens.

"Low-income people who cannot afford health insurance are in jobs that don't offer health insurance,"
he said.
"And then with CHIP programs being cut or not being funded adequately, there is a big segment out there not covered."

Only 55 percent of Texans have access to employer-sponsored insurance, below the national average of 63 percent, according to the Texas Medical Association. For small businesses – which provide about half the state's nonfarm, private-sector jobs – coverage drops to 37 percent.
...
Strain on hospitals

The strain of supporting uninsured Texans pressures hospitals financially and in the quality of care, experts say.

Total uncompensated care – including bad debt from people who can't pay their bills and charity care that hospitals agree to provide – increased 78 percent, from $5.6 billion in 2001 to $10.1 billion in 2005,
according to the Texas Hospital Association.

Uninsured patients are more likely than their insured counterparts to forgo or delay treatment for acute illnesses or injuries, to go without needed treatment for chronic conditions or illnesses and to die prematurely.

Besides the dangers to those who go without insurance, the situation also creates a drag on the state's economy,
said Nancy Williams, president of the Health Industry Council of the Dallas-Fort Worth Region.
Uninsured patients create higher health care costs for everyone as a result of the inherent cost shifting.

"The uninsured is an issue because the insured can't handle it,"
Ms. Williams said.

A study by Families USA, a Washington-based nonprofit group that advocates for universal health care, found
in 2005 that employer-sponsored family coverage in Texas costs $1,551 more per year as a result of the uninsured.


The problem of the uninsured is again getting attention from politicians. Presidential candidates are floating proposals to increase the ranks of insured Americans and even to provide universal health coverage.

Massachusetts is rolling out a plan that will cover nearly all of its residents. Politicians in California, New York and Pennsylvania are talking about doing the same.

In Texas, solutions have come in a more piecemeal fashion.

In the recent legislative session, lawmakers restored many of the funding cuts made in 2003 to the Children's Health Insurance Program. CHIP is designed for children of families who earn too much for Medicaid but not enough to buy private health insurance.

Since the cuts, CHIP enrollment had dropped from a high of 529,000 in May of 2002 to 300,800 this month,
according to the Texas Health and Human Services Commission.

Lawmakers also agreed to settle a Medicaid-related lawsuit by spending $707 million to increase dentists' payments by 50 percent and physicians' 25 percent, and to dispatch up to 40 mobile labs into inner-city neighborhoods and impoverished colonias.

Mr. Homer, the former TMA president, said
the state was funding two-thirds of the actual cost of Medicaid – "which means many physicians opt out of this program, which means more people don't have access to health care."


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