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The States With the Worst Healthcare Systems


Stashed in: #health, Awesome, xkcd!, America!, Maps!, Boston, Healthcare, Mississippi, Maps

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Massachusetts -- which has had a version of Obamacare since it was Romneycare -- is tied for the 2nd best performing healthcare system in the USA. Dead last, as always: Mississippi. Might it be related to the fact that you can't get Medicaid in Mississippi unless you have kids and make LESS THAN $6,800 A YEAR for a family of four?

Also: South Carolina, where you at with the dental care? Generally SC seems to have above-average healthcare, but they also have an awful lot of people who are missing 6 or more teeth!

States with worst eating habits and highest BMI.

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States with worst drivers.

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States with furry animals.

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I think I'm starting to see a trend.

There's definitely correlation between those things you mention, Greg.

It shows us what the populations of those states value.

Also, Joyce, I think a significant number of people in Mississippi have no income and therefore qualify.

Which is a problem in and of itself.

It is strange that there is such high variance of healthcare coverage in America.

The Atlantic article you stashed is a good read and breaks it down well:

http://theatlantic.com/health/archive/2014/05/the-states-with-the-worst-performing-healthcare-systems/361514/

You want to talk about high variance in healthcare coverage in the USA?

In San Francisco 10 years ago, they spent $12.9 MILLION annually on just the hospital bills at a single hospital (SF General) for the top 225 most frequent EMS users. That is $57.3K per person for those 225 people. Oh, but that's not all! The top 362 most frequent EMS users in San Francisco cost $11.6 MILLION in EMS bills over an 18 month period -- so that's about another $24K annualized for each of them. Add it all up and you're talking about something like the entire net income of maybe two decent programmers being poured into each of a couple hundred indigent people's healthcare by the city of San Francisco. And remember, SF has about 7,000 homeless people at any given time -- no matter how much money they spend, that number has not reduced in the slightest. (Factoids from this fire department preso: http://www.sfgov2.org/ftp/uploadedfiles/mocj/CommInvlv_News/FD_HOME_Team.pdf)

None of this is counting actual tax money going to housing and other services for San Francisco's homeless, which amounts to $167 million a year and is more than the budgets of the Recreation and Park or Public Works departments. The numbers above are STRICTLY healthcare costs and only for the few most frequent users of the EMS system, who are disproportionately "chronic inebriates".

So even healthcare for the indigent in the USA is a very skewed proposition. In Mississippi, a family with 2 kids can't get Medicaid unless they make less than $6,800 -- but in San Francisco the city pays almost $100K per person for indigent healthcare.

That's better than Los Angeles.  They just go bankrupt and close their public hospitals.  They've been in a neverending death spiral since 2004, and now our indigent can't get treatment at any cost.

"The public hospital system in Los Angeles County, California, is in the midst of a major fiscal crisis that has already led to a serious reduction of capacity and could continue to worsen. Given the importance of the public system in a county where 30 percent of the population is uninsured and private hospitals provide very little uncompensated care, what happens in L.A. County is a harbinger for other cities and counties in the United States. This article highlights the issue of the extent to which local taxpayers, as opposed to state or federal taxpayers, are responsible for the continued operation of public hospitals and safety-net facilities in their communities."

Both San Francisco and Los Angeles sound terrible.

How were things allowed to get so bad?

That's interesting. I asked Google.   The reasons seem to be...

1) Fraud.  http://www.californiahealthline.org/articles/2013/4/4/experts-forecast-trend-of-state-hospital-closures-under-aca

2) Financial problems from general economy, lower reimbursement rates including the rate set by medicare and medicaid, charity care, fewer admissions, and the duality of costly new upgrades, equipment, and procedures to keep inline with best care practices and more specifically, Earthquake retrofitting and unfunded employee pensions.

https://scribeamerica.com/newblog/hospitals-close/

So basically human nature and entropy.

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