In the United States, we pay a lot more for our health care than other wealthy countries, but we are no healthier. Missourians actually pay even more per capita than the U.S. average, and are even less healthy. (Missouri is ranked 39th in the nation in overall health, and we are the 9th most obese state.) A big part of the problem is the way we pay for health care, according to Harold Miller, executive director of the Center for Healthcare Quality and Payment Reform.
Total Medicaid spending growth (dark blue) compared to state spending (light blue). In 2009 and 2010 state spending fell sharply as federal stimulus money came to the rescue. Now the reverse is happening.
During the Great Recession, as the ranks of poor and unemployed swelled, enrollment in Medicaid shot up, growing by 7.8 percent in 2009. At the same time, state tax revenues collapsed by nearly 17 percent. States couldn't afford to pay their share of Medicaid costs, and Congress came to the rescue with the Recovery Act, boosting federal Medicaid funding by around $103 billion. But the recovery dollars ran out in June, and now states are facing the biggest yearly increase in Medicaid costs in history, according to projections by the Kaiser Family Foundation. Missouri already spends over a quarter of the state budget on Medicaid.
Able to clean teeth, like a hygienist, but also fill cavities like a dentist. If you've never heard of a registered dental practitioner, it's probably because they are only legal in two states, Alaska and Minnesota. Like nurse practitioners, these mid-level providers are aimed at helping underserved rural areas.
In 2019, the average Missouri family will be $1,471 richer. That’s how much the average family will save on health care each year once Obama’s reform law takes full effect, according to a new study by Families USA, a pro-reform group.
There’s a doctor shortage in rural America. This is not news – just the opposite – it’s been going on for ages. Even old Doc Adams, the country doctor in “Gunsmoke,” was constantly overworked. In one episode, when he finally gets a vacation, he’s kidnapped by outlaws in need of his services. Present-day Missouri ain’t Dodge City, Kansas. But many rural doctors are still overstretched.
For people with chronic conditions, getting Medicaid services can be a confusing, disjointed experience, shuffling from provider to provider. Under a provision of the Affordable Care Act, states can apply for federal money to help coordinate that care. Missouri did just that, and the news came today that the state will be the first to get this kind of funding under the ACA. Missouri’s application was aimed at helping people with chronic mental health issues.
I ran a marathon in Joplin last weekend – the second annual “Mother Road Marathon,” along Route 66. It was hot, there was a head wind, and it was a long slow day. My time was exactly one hour longer than my first marathon six months ago. I didn’t have a good excuse for my slowness – I’ve just been lazy about training. But for locals in Joplin, training for this race was truly challenging.
End-of-life decisions can be wrenching for families. In the early 2000s, the case of Terri Schiavo riveted the nation, as her family battled over whether to remove her feeding tube or keep her on life support. Now, 44 states have so-called “family consent” laws, which help determine which family member should make health care decisions. Missouri is one of the six states with no such law, putting families and doctors in legal limbo. But a bill headed for the Missouri legislature could change that.
Two weeks ago, President Obama told the nation, “Washington has to live within its means.” As Democrats and Republicans continue to scour the federal budget for over a trillion dollars in possible cuts, one group very likely to be affected is rural hospitals in the Midwest and across the nation.
Health care premiums are at a record high – up nine percent since last year. A survey released Tuesday shows the average family is now paying over 15 thousand dollars a year on health care premiums. KBIA’s Jacob Fenston reports the rising costs are affecting Missourians as well.