Home to thousands of older adults, the tropical paradise of Florida isn’t so sunny in terms of overall health care. In an age where more Americans have access to health care than ever before, Florida still has work to do compared to other states.
Determining the “best health care” among states is a result of findings generated by a diverse set of metrics and analytics, and costs vary from state to state based on a population’s overall need, access, technology, and other tangible factors.
The U.S. Health System Data Center publishes an annual “Scorecard on State Health System Performance.” This is a measure of access, prevention/treatment, avoidable hospital use and cost, healthy lives, and equity. Its average findings show Florida 39th, with its lowest marks in the category of access (41st.).
According to Aiming Higher: Results from a Scorecard on State Health System Performance, 2017 edition, The Commonwealth Fund, March 2017, Florida ranked
44th in prevention and treatment, 45th in avoidable hospital use and costs, 20th in healthy lives, and 33rd in equity The lowest-ranking indicators in the access category were uninsured adults (50th), uninsured children (45th), and adults who went without care due to cost (46th).
If Florida were to improve to the level of the best-performing state, the U.S. Health System says that 1, 893,354 more adults would have to be insured; 1,586,865 fewer adults would go without needed care because of cost; and 102,982 fewer emergency room visits would have to occur among Florida’s Medicare population. Its top five states for best health care were Vermont, Minnesota, Hawaii, Rhode Island, and Massachusetts.
The Uninsured: A Major Detriment
The number of Americans without health insurance is at an all-time low due to the Affordable Care Act, known as Obamacare, however Florida’s decline in national rankings is tied directly to its uninsured population. According to healthinsurance.org, the numbers of its uninsured continue to be among the nation’s highest.
On a political level, Gov. Rick Scott was a vocal opponent of the health care reform law. Florida rejected federal loans to evaluate a state-run exchange and was the lead plaintiff in the U.S. Supreme Court case challenging the ACA and rejected Medicare expansion.
Despite the opposition, the bill contained enough quality provisions that eight insurance companies sold plans within the state, and that generated a higher than expected enrollment.
One of the major legislative sticking points is that anyone without health care coverage, either through an employer or a public care program, is subject to a tax penalty. Portions of this politically controversial legislation are targeted for revisions and restructuring in 2018.
According to the Florida Policy Institute, Florida ranks 45th in the nation for its rate of uninsured residents. Based on U.S. Census Bureau statistics, 2.6 million are without coverage (13.3 percent of the population). Florida’s rate is three times higher than that of Vermont, where only 3.8 percent are without health care coverage. The only four states with higher rates than Florida are Texas (17.1 percent), Georgia and Oklahoma (13.9 percent each), and Alaska (14.9 percent).
Kimberly Leonard, a former health care reporter at U.S. News & World Report, commented on the effect of Obamacare. “The cost of Obamacare rose as millions of low-income people unexpectedly enrolled in public health care coverage rather than private insurance. The numbers indicate that the federal government fell far short in estimating how many people would enroll in government coverage rather than tax-subsidized, private health insurance.” She also reported that 68 million people were enrolled in Medicaid and Children’s Health Insurance programs in 2016—a jump of 16 million above the government’s anticipated figure in 2010.
More data…more differences
Another “Best States for Health Care” listing, published by U.S. News & World Report, used data compiled by McKinsey & Company. Its analysis was in the categories of overall health, access to care, availability of preventive medicine, and quality dental treatment. The top five states, according to U.S. News, were: Hawaii, Massachusetts, Minnesota, New Hampshire, and Iowa. Florida ranked 31st.
A broader set of variables, included overall health care, education, crime, infrastructure, opportunity, economy, and government provided a different outcome, with Florida ranking 24th with respective scores of 31, 29, 37, 11, 43, 7, and 9. However, eight hospitals in South Florida were among its Top 20 list: Baptist Hospital of Miami (6); Cleveland Clinic Florida (8); Holy Cross Hospital (10); University of Miami Hospital (12); and Memorial Regional Hospital (14). Boca Raton Regional, South Miami, and West Kendall Baptist were tied (16).
WalletHub.com (owned by Evolution Finance Inc.) is another example of how data and conclusions differ from source to source. Its findings showed Hawaii as the top state for health care (67.36), followed by Iowa (66.62), Minnesota (66.52), New Hampshire (66.54) and the District of Columbia (65.47). Florida ranked 43rd (46.07), and was near the bottom of “Lowest Percentage of Insured Adults Aged 18-64.” WalletHub used 35 different metrics, including cost, access, and outcome analysis.
The Department of Health and Human Services says health care spending will grow at a faster rate than the national economy over the next decade. Projections are $3.35 trillion, or more than $10,000 per person. Five percent of the population (mostly frail or ill) will account for half the spending in any given year.
Health care is the Great American Puzzle. How the pieces fall into place will have a long-lasting effect.