Health Care In The States

Study: Residents In Tenn., Fla. And Ga. Saw Biggest Jump In Access Problems

By Phil Galewitz

May 8th, 2012, 7:00 AM

Adults in nearly every state saw their access to health services worsen during over the past decade, with Tennessee, Florida and Georgia having the greatest increase in people reporting having an unmet medical need, according to a study released Tuesday.

The three states had at least a 9 percentage point jump in the proportion of adults under 65 who said they had unmet medical needs due to cost, according to the report released by the Robert Wood Johnson Foundation, which was conducted by researchers at the Urban Institute.

Gordon Bonnyman, executive director of Tennessee Justice Center, an advocacy group, said he was not surprised Tennessee had the largest increase, at almost 11 percentage points. He noted Tennessee cut nearly 300,000 people from its Medicaid program in the middle part of the decade due to spending cuts. “It’s simple cause and effect. … It’s heartbreaking.”

Urban Institute researchers also conducted a similar study that was published published Monday in Health Affairs that showed tens of millions of adults had reduced access to health care over the decade.

States with the largest percentage of residents with unmet needs because of cost in 2010 were Mississippi (26.0%), Texas (25.3%) and Florida (25.1%).  States with the lowest were North Dakota (8.2%), Massachusetts (8.7%) and Hawaii (9.7%).

Over the past decade, rates of unmet medical needs rose in 42 states. The share of adults receiving routine check-ups fell in 37 states; and the share of adults who had access to dental care declined in 29 states. In all, 49 states experienced a significant decline on at least one of the three measures over the decade. West Virginia and the District of Columbia did not.

Adults without health insurance had it much worse than those with coverage.

In 2010, almost half of uninsured adults (48.1%) had an unmet health need due to cost, compared to 11.2 percent of insured adults. “This indicates that the health care safety net is not acting as an effective substitute for health insurance coverage when it comes to providing basic health care to the uninsured,” said Genevieve Kenney, the study’s lead author and a senior fellow at the Urban Institute.

Still, the uninsured had an easier time accessing care in some states than others.  For example, 26 percent of uninsured adults in Alaska said they had an unmet medical need in 2010, compared to 57 percent in Kentucky.

5 Responses to “Study: Residents In Tenn., Fla. And Ga. Saw Biggest Jump In Access Problems”

  1. Sarah says:

    Problems accessing health care? Yet, these hayseed populations groups keep voting for Republicans. I’m convinced, there must be something in the water down there. They can’t be that stupid, can they?

  2. stan says:

    No, they’re moral. They vote for what they think is right, as do progressives with relatively high incomes who would benefit from Republican tax cuts but who think the Republican policy agenda is wrong.

  3. Darlene Rye says:

    Hello my name is Darlene…I had no Health Insurance…I ended up with Lung Cancer…so it was worse…they said I had to wait 2 years before i could get medicare… then on top of that…to get a supplement insurance or regular health insurance would cost me alot because i had cancer…then if that is not bad enough i try and get help and now they say I make to much money…So what is a person to do…….DARN IF YOU DO AND DARN IF YOU DON’T….i don’t cuss so put the right word in there…its a good thing i’m not president…I would do a little house cleaning…the old people are going hungrey to buy medicine… and the spoiled young kids gets there educations paid for them…let them work..oh I forgot they don’t know what work is. Doctors live high on the hog charging out rages prices…so if your poor or on disability.. don’t plain on a worry free life…what’s this world coming too?

  4. MDNotes says:

    First, you must consider that the study was conducted by the RWJ Foundation and the Urban Institute. Both of these organizations support the ACA and support policies of mostly Democratic members of Congress. That doesn’t invalidate their findings, of course, but it must be remembered. The fact that Kaiser also adds their color commentary regarding the reduction in Medicaid members in Tennessee is also testament to this, as the number they cite represents less than 5% of the total population and is in the middle of the decade. They also provide a quote from an individual saying it was “…cause and effect.” The fact that Kaiser includes this is very telling, as there is no substantiation of a cause and effect relationship between that event. It’s also disingenuous to not mention that this is a multi-variable problem, and most evidence suggests multiple culprits, including the reimbursed-based healthcare system in the US promoted by Medicare and the government, the largest insurer and payer of healthcare services in the country. The report also explicitly states that the authors believe the ACA will increase access to healthcare due to the solutions it contains. There is no evidence to suggest this is true.

    Second, it’s based upon survey data, which is an awful way of defining “need.” They also did not adequately account for changes in population as well as limitations of survey design.

    The report does an absolutely horrible job of evaluating the issue of cost. There is no root cause analysis. Ultimately, whenever demand or consumption of a product declines, it is important to explore why this is the case when supply has not declined. It should be easy for most to see that government intervention in the market has drastically increased the costs and thus decreased the ability to access healthcare products and services. From pharmaceutical company subsidies to subjective Medicare product and service reimbursements, the government heavily regulates and controls the payer system in the country. For profit insurance companies follow their rules and will, like any other company, try to find savings in the leftover areas. This has led to awful results and causes people to blame insurance companies instead of the government. While insurance companies are also at fault, they are being incentivized and heavily regulated by the government. These underlying problems must be fixed before access will increase. Forcing insurance companies to change their policies without changing the governments stance on reimbursement-based healthcare is a lost cause and has been shown repeatedly not benefit patients and consumers.

  5. Dr. John Michael Briley, DNP says:

    It is because of the fact the Tennessee remains one of those states in which restrictions are allowed to exist which prevents the Advanced Practice Nurse from practicing to his/her fullest educational ability. Until organized medicine such as the Tennessee Medical Assocation seeks to truly have the patient’s interest(s) at paramount, access will continue to be an issue.

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