Oklahomans who rely on the state’s healthcare system may not be surprised that it achieves a low ranking in a recent study, but a study author’s comment to the press drives the extent of the problem home.
“Oklahoma and Mississippi stand out for poor performance even among poor performing states,” David Radley, lead author of the Commonwealth Fund’s 2019
Scorecard on State Health System Performance, said during a teleconference reported by the Tulsa World.
God bless our friends in Mississippi. Oklahoma’s healthcare system ranked 50th among 50 states and Washington, D.C., just ahead of Mississippi at No. 51. Oklahoma ranked 49th last year.
Hawaii, Massachusetts and Minnesota ranked Nos. 1, 2 and 3, respectively, the same as in 2018.
Analysts “found that rising health insurance premiums are being driven by higher costs, especially for prescription drugs and outpatient services, and not because of greater utilization of the system,” the newspaper said.
The report also says deaths from suicide, alcohol and drugs have risen over a 12-year period, though the effects of each were different in different regions of the country.
In Oklahoma, despite a focus on opioid addiction and abuse, the rate of deaths from alcohol actually grew faster than from drug overdoses from 2005 to 2017, the World reported. The rate of fatal drug overdoses declined from 2013 to 2017, while the rate of alcohol-related deaths continued to increase.
The State Health System Performance rankings were based on 47 criteria divided into five categories: access and affordability, prevention and treatment, avoidable hospital use and cost, healthy lives, and disparity.
Among the rankings for Oklahoma:
- 50th for uninsured adults
- 49th for access and affordability
- 49th for elderly patients receiving high-risk drugs
- 49th for preventable deaths
- 49th for colorectal deaths
- 48th for healthy lives
- 46th for avoidable hospital use and cost
- 45th for disparity
- 42nd for prevention and treatment
- 5th for children 19-35 months with recommended vaccinations
- 5th for home health patients enrolled in Medicare.
Indicators that improved the most (meaning there were fewer of each of them) from 2018 to 2019 were:
- Home health patients without improved mobility
- Hospital admissions for pediatric asthma
- Diabetic adults without an annual hemoglobin A1c test.
But indicators that got worse were:
- Children without a medical and dental preventive care visit
- Preventable hospitalizations ages 18-64
- Hospital 30-day mortality rate.
“Several states that most recently expanded eligibility for their Medicaid programs [something Oklahoma has not done] saw meaningful gains in access to health care,” the study report says.
“The widespread gains in people’s coverage and access to health care following the ACA [Affordable Care Act, aka Obama Care] passage in 2010 have largely stalled since 2015, with even some ominous erosion from 2016 to 2017 in 16 states. Stalled gains are attributable to lack of Medicaid expansion in 17 states, people with incomes just over the eligibility threshold for marketplace subsidies (about $48,560 for an individual) and many in employer plans [having] high premium costs.”
Children’s Healthcare and Well-Being in Oklahoma Rank Low
In another study just released, the 2019 Kids Count Data Book from the Annie E. Casey Foundation, Oklahoma ranks 42nd in the nation for the overall well-being of its children, a step up from 44th last year. This study is based on Oklahoma-specific census data with help from the Oklahoma Policy Institute, according to The Oklahoman.
This report focuses on 16 various indicators within economic well-being, education, health outcomes and family and community connections, the newspaper said.
New Hampshire ranked No. 1 in overall child well-being, followed by Massachusetts and Iowa. (Mississippi ranks 48th in this study.)
Among the rankings for Oklahoma:
- 45th in education
- 43rd in health outcomes
- 40th in family and community connections
- 35th in economic well-being.
Other findings within these categories:
- 71% of fourth graders do not read proficiently
- 76% of eighth graders are not proficient in math
- 17% of high schoolers do not graduate on time
- 1% percent of babies have low birth weight
- 8% of children do not have health insurance
- 4% of teens abuse alcohol or drugs
- 36% of children live in single-parent homes
- 11% of children living in high-poverty areas
- 30 teenage births per 1,000
- 21% of children live in poverty
- 28% of children’s parents lack secure employment
- 26% of children live in homes with a high housing cost burden
- 8% of teenagers are not in school and not working.
The report’s authors found a country with advantages that Oklahoma is not yet fully participating in. “The data reveal, in the United States today, more parents are financially stable and living without burdensome housing costs. More teens are graduating from high school and delaying parenthood. And access to children’s health insurance has increased compared to just seven years ago.”
“There is definitely hope and lots of great examples of ways that things are improving,” Gene Perry, communications director for the Oklahoma Policy Institute, told The Oklahoman. “For Oklahoma, compared to the nation as a whole, we’re improving, but not as quickly. So, there is more we can do to catch up with those trends.”
Longer Short-Term Health Insurance Policies May Fill Healthcare Gap in Oklahoma
As part of Oklahoma policymakers’ plans to study Medicaid expansion ideas or shore up the state’s health insurance market, lawmakers may allow consumers to buy short-term, limited-duration insurance plans for up to 36 months — an expansion to six times longer than the current limit, The Oklahoman reports.
The move, pushed forward by Republicans on a party-line vote, would give consumers more options for buying health insurance and prevent the government from blocking plans that lack key benefits and consumer protections.
Short-term plans are often purchased as temporary or gap coverage — such as when someone is between jobs. Others turn to them because they cost a fraction of what Affordable Care Act-compliant plans cost on the federal exchange.
But they are cheaper because they often lack key benefits, such as prescription drug, maternity and cancer coverage, which are required for plans sold on the federal exchange. Additionally, short-term plans can reject individuals with pre-existing conditions, which the federal law prohibits.
After Trump Administration rules loosened requirements in August, then-Oklahoma Insurance Commissioner John Doak called on Oklahoma lawmakers to change state laws restricting temporary insurance plan terms to six months to institute a 36-month limit. Current Insurance Commissioner Glen Mulready, a fellow Republican, supported the plan.
“Supporters of the plans and rule change say they will give more people affordable insurance options, reducing the number of uninsured,” the newspaper says.
“It harkens back to the old days when the market was more of a wild west,” Sara Collins, vice president of health-care coverage and access for the Commonwealth Fund, told the Oklahoman. “It can be a very risky plan for people to buy compared to other insurance policies that might be more comprehensive.”
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