The health care status quo is not good enough

Health and Human Services Secretary Kathleen Sebelius issued reports on Friday detailing the problems with the "health care status quo" across the country. You can find the reports at HealthReform.gov. The report for Iowa is here, and I've also posted it after the jump. Among other things, it shows the percent increase in family health insurance premiums since 2000 and the percentage of uninsured Iowans.

A couple of points jumped out at me:

• Choice of health insurance is limited in Iowa. Wellmark BC and BS alone constitutes 71 percent of the health insurance market share in Iowa, with the top two insurance providers accounting for 80 percent.11

Iowa is not unusual in this regard. Most insurance markets in the United States are dominated by one or two companies. My family's Wellmark premiums went up 10 percent this year alone. Speaking of which, the annual salary of Wellmark's CEO has "nearly doubled" in the past five years to about $2.5 million.

• Choice is even more limited for people with pre-existing conditions. In Iowa, premiums can vary, within limits, based on demographic factors and health status, and coverage can exclude pre-existing conditions or even be denied completely.

I know a family in Des Moines who were unable to purchase health insurance at any price because the mother has a thyroid condition. They are now covered through the father's employer, but if he loses his job they will have no health insurance options.

Two more reasons why we cannot settle for health care reform without a public option, or with a fake public option. I was glad to see several House Democratic caucuses affirm that they will fight any health care bill lacking "a real and robust public option that lives up to our criteria".

Click "there's more" to read the whole report, with supporting footnotes.

THE HEALTH CARE STATUS QUO: Why Iowa Needs Health Reform

Congress and the President are working to enact health care reform legislation that protects what works about health care and fixes what is broken. Iowans know that inaction is not an option. Sky-rocketing health care costs are hurting families, forcing businesses to cut or drop health benefits, and straining state budgets. Millions are paying more for less. Families and businesses in Iowa deserve better.  

IOWANS CAN'T AFFORD THE STATUS QUO

- Roughly 1.9 million people in Iowa get health insurance on the job(1), where family premiums average $12,206, about the annual earning of a full-time minimum wage job.(2)

- Since 2000 alone, average family premiums have increased by 88 percent in Iowa.(3)

- Household budgets are strained by high costs: 19 percent of middle-income Iowa families spend more than 10 percent of their income on health care.(4)

- High costs block access to care: 8 percent of people in Iowa report not visiting a doctor due to high costs.(5)

- Iowa businesses and families shoulder a hidden health tax of roughly $600 per year on premiums as a direct result of subsidizing the costs of the uninsured.(6)

AFFORDABLE HEALTH COVERAGE IS INCREASINGLY OUT OF REACH IN IOWA

- 10 percent of people in Iowa are uninsured, and 71 percent of them are in families with at least one full-time worker.(7)

- The percent of Iowans with employer coverage is declining: from 71 to 65 percent between 2000 and 2007.(8)

- Much of the decline is among workers in small businesses. While small businesses make up 76 percent of Iowa businesses,(9) only 39 percent of them offered health coverage benefits in 2006 -- down 2 percent since 2000.(10)

- Choice of health insurance is limited in Iowa. Wellmark BC and BS alone constitutes 71 percent of the health insurance market share in Iowa, with the top two insurance providers accounting for 80 percent.(11)

- Choice is even more limited for people with pre-existing conditions. In Iowa, premiums can vary, within limits, based on demographic factors and health status, and coverage can exclude pre-existing conditions or even be denied completely.

IOWANS NEED HIGHER QUALITY, GREATER VALUE, AND MORE PREVENTATIVE CARE

- The overall quality of care in Iowa is rated as "Average."(12)

- Preventative measures that could keep Iowans healthier and out of the hospital are deficient, leading to problems across the age spectrum:

- 11 percent of children in Iowa are obese.(13)

- 21 percent of women over the age of 50 in Iowa have not received a mammogram in the past two years.

- 36 percent of men over the age of 50 in Iowa have never had a colorectal cancer screening.

- 74 percent of adults over the age of 65 in Iowa have received a flu vaccine in the past year.(14)

The need for reform in Iowa and across the country is clear. Iowa families simply can't afford the status quo and deserve better. President Obama is committed to working with Congress to pass health reform this year that reduces costs for families, businesses and government; protects people's choice of doctors, hospitals and health plans; and assures affordable, quality health care for all Americans.

1 U.S. Census Bureau, Current Population Survey. HIA-4 Health Insurance Coverage Status and Type of Coverage by State--All Persons: 1999 to 2007, 2007.

2 Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table X.D.

Projected 2009 premiums based on Centers for Medicare and Medicaid Services, "National Health Expenditure Data," available at http://www.cms.hhs.gov/nationa...

3 Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2000, Table II.D.1.

Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table X.D.

Projected 2009 premiums based on Centers for Medicare and Medicaid Services, "National Health Expenditure Data," available at http://www.cms.hhs.gov/nationa...

4 Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2006.

5 Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007.

6 Furnas, B., Harbage, P. (2009). "The Cost Shift from the Uninsured." Center for American Progress.

7 U.S. Census Bureau, Current Population Survey. Annual Social and Economic Supplements, March 2007 and 2008.

8 U.S. Census Bureau, Current Population Survey. HIA-4 Health Insurance Coverage Status and Type of Coverage by State--All Persons: 1999 to 2007, 2007.

9 Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table II.A.1a.

10 Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2001, 2006, Table II.A.2.

11 Health Care for America Now. (2009). "Premiums Soaring in Consolidated Health Insurance Market." Health Care for America Now.

12 Agency for Health Care Research and Quality. 2008 State Snapshots. Available http://statesnapshots.ahrq.gov/.

13 Child and Adolescent Health Measurement Initiative. 2007 National Survey of Children's Health, Data Resource Center for Child and Adolescent Health.

14 Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007.

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