Some gains in trends for the poor and unin­sured, but no cause for cel­e­bra­tion

Modern Healthcare - - MODERN HEALTHCARE -

De­spite im­prove­ment in unin­sured num­bers, don’t cel­e­brate just yet

Last week of­fered the usual steady diet of re­ports, stud­ies and analy­ses in the news, inside and out­side of health­care. But as is of­ten the case to­day, the data are in­ter­con­nected. One of the high-pro­file re­ports came cour­tesy of the fed­eral gov­ern­ment, specif­i­cally the U.S. Cen­sus Bureau’s an­nual re­view of the state of our na­tion when it comes to poverty sta­tus and the lack of health in­sur­ance cov­er­age. This year, while the find­ings cer­tainly aren’t cause for ex­ces­sive ex­u­ber­ance, they do show im­prove­ment.

The per­cent­age of unin­sured fell, and the poverty level ticked down (sta­tis­ti­cally it re­mained flat) de­spite a lowsim­mer econ­omy. But those find­ings, as mod­est as they might be, beat the al­ter­na­tive bad news on both of those fronts to which we have be­come ac­cus­tomed.

The fig­ures on the unin­sured de­liv­ered the strong­est move­ment based on the over­all per­cent­ages. Ac­cord­ing to the cen­sus fig­ures, the rate of U.S. unin­sured dropped to 15.7% last year from 16.3% in 2010, which was the largest drop since the fed­eral gov­ern­ment ad­justed its re­port­ing method­ol­ogy in 1999.

Where did most of the im­prove­ment oc­cur? A large drop in the num­bers of unin­sured young adults led the way, with the per­cent­age of those ages 19-25 lack­ing health cov­er­age fall­ing to 27.7% last year from 29.8% in 2010. That rep­re­sents half a mil­lion ad­di­tional young men and women who had health in­sur­ance cov­er­age.

Credit has to go to one of the most pop­u­lar pro­vi­sions of the Pa­tient Pro­tec­tion and Af­ford­able Care Act, al­low­ing young adults to re­main on their par­ents’ in­sur­ance cov­er­age up to age 26. It’s an age group that con­tin­ues to strug­gle with un­em­ploy­ment at con­sid­er­ably higher per­cent­ages than the na­tional av­er­age, so the ex­tended cover- age is most wel­come for this gen­er­a­tion. And their par­ents.

Mean­while, the na­tional poverty rate set­tled to 15% in 2011 from 15.1% in the pre­vi­ous year, still a pos­i­tive sign since most an­a­lysts had pre­dicted a fourth straight year of higher poverty lev­els. Ac­cord­ing to the Cen­sus Bureau, gov­ern­ment pro­grams such as Med­i­caid as well as some re­duc­tions in un­em­ploy­ment lev­els helped keep the poverty rate in check. Un­for­tu­nately, the level at which the poverty re­mained static rep­re­sents a decades-long high. While the num­bers are bet­ter than expected, we all ex­pect this na­tion to do bet­ter than that. The vot­ers are likely to make that point to our na­tion’s lead­ers on Nov. 6.

Still an­other re­port last week, this one from the Agency for Health­care Re­search and Qual­ity, posted some good news on the pa­tient-safety front.

Ac­cord­ing to AHRQ, an in­ter­ven­tion pro­gram known as the Com­pre­hen­sive Unit-based Safety Pro­gram, or CUSP, launched na­tion­wide in 2009 to pre­vent po­ten­tially deadly cen­tral-line in­fec­tions among hos­pi­tal­ized pa­tients, posted a 40% re­duc­tion in cases, which the agency es­ti­mated saved more than 500 lives and some $34 mil­lion in costs.

At a time when pa­tient-safety gains still seem to be frus­trat­ingly rare, if they are recorded at all, such im­prove­ment, es­pe­cially when so much is at stake, should be rec­og­nized.

Even as the cur­rent eco­nomic oper­at­ing en­vi­ron­ment forces health­care lead­ers to fret more than ever over re­im­burse­ment rates, profit mar­gins and any num­ber of fi­nan­cial per­for­mance met­rics, it’s im­por­tant to re­mem­ber the real bot­tom line in this in­dus­try: the sci­ence of car­ing for hu­man be­ings. Our health­care sys­tem isn’t the best in the world, by far, but our world-class care­givers continue striv­ing to make it so.


As­sis­tant Manag­ing


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