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doctor’s corner

RATES &

RATINGS

by Allen Weiss, MD, MBA, FACP, FACR RMV
President and CEO, NCH HealthcareSystem
The following op-ed was published by the Naples Daily News on
Sunday, October 21, 2018.

stoundingly, Florida has the fourth-from-the-bottom worst people with health insurance has increased significantly over the
medical care in America according to the Commonwealth past five years, with more than 20 million individuals newly insured
AFund’s 2018 metrics. Further, Florida has dropped four [nationally]. Most of these individuals were able to enroll in cover-
places this past year based on five criteria: access/affordability, age offered through the Medicaid program, their employer, or the
prevention/treatment, avoidable hospital use/cost, healthy lives, individual market as a result of coverage programs and insurance
and disparity. Only Louisiana, Oklahoma, and Mississippi rate market reforms authorized by the Affordable Care Act (ACA).”
lower than Florida. Hawaii, a Blue Zones state that has embraced • https://www.aha.org/system/files/2018-04/report-cover-
Medicaid expansion, is ranked first in the nation. age-overview-2018_0.pdf

Specific Florida rankings include: “adult rich/poor insurance
How does Collier County’s health relate? While Hawaii ranks
access disparity” 43rd; “disparity in rich/poor adults who report
first of 50 states and the District of Columbia in overall health status
poor health” 44th; “adults without a usual source of care” 45th;
according to the Commonwealth Fund, Southwest Florida (a Blue
“adults who went without care because of cost” 47th; “adult with-
Zones region like Hawaii) ranks first in the nation for longest life
out all age-appropriate vaccines” 49th; and “hospital readmissions
expectancy—one that is also lengthening. Moreover, Hawaii has im-
and Medicaid reimbursement per person” 50th. proved this past year in access/affordability and prevention/treatment.
• https://interactives.commonwealthfund.org/2018/state-
scorecard/state/florida/ Locally, Southwest Florida also enjoys improvement as the healthiest
and happiest region three consecutive years according to the Gallup-
Florida also remains one of eighteen states rejecting funding to Sharecare poll. Had Florida accepted Medicaid expansion, Collier
expand Medicaid coverage to people in households with income at County’s 17% of the 358,000 population who are uninsured (accord-
or below 138% of the federal poverty level. Florida’s current unin- ing to the Collier County Public Health Department) would have
sured rate is 13.3%, exceeding the national average of 9.4%. These benefited, not only bringing equity locally but also matching residents’
facts, according to the U.S. Census Bureau’s most recent estimates, wellness in the 32 expansion states and the District of Columbia.
show 2.6 million Floridians do not have health insurance cover- Florida’s fear of increased cost by embracing expansion has
age. Only four states have higher percentages of uninsured: Texas proven unfounded. Florida should emulate the success of Hawaii
17.1%, Georgia and Oklahoma 13.9%, and Alaska 14.9%. and Collier to decrease cost and improve health.
• https://www.fpi.institute/uninsuredratedeclines/ • https://www.nejm.org/doi/pdf/10.1056/NEJMp1613981
• https://www.kff.org/medicaid/issue-brief/the-effects-of-
A New England Journal of Medicine Special Article, entitled medicaid-expansion-under-the-aca-updated-findings-from-a-
“Mortality and Access to Care among Adults after State Medicaid
literature-review-march-2018/
Expansions,” validated that mortality reductions are greatest among
older adults, nonwhites, and residents of poorer counties with Helping everyone across Florida and our nation live longer,
Medicaid expansion. In expansion states four measures improved: happier, and healthier lives is the right thing to do and should be
(1) Medicaid coverage increased by 2.2%; (2) self-reported health everyone’s purpose.
status of “excellent” or “very good” went up 2.2%; (3) medically
insured grew by 3.2%; and (4) delayed care dropped by 2.9%.
• https://www.nejm.org/doi/full/10.1056/NEJMsa1202099 P.S. DO YOU HAVE A COLLEAGUE OR FRIEND

“Meaningful healthcare coverage is critical to living a produc- WHO WOULD BE INTERESTED IN UPDATES ?

tive, secure, and healthy life,” is a wise quote from the American Please enter their email address at nchmd.org/straighttalk ,
Hospital Association (AHA). As a healthcare professional and an and we will add them to our complimentary mailing list.
AHA Board member, I fully support this position. “The number of

46 Life in Naples | December 2018