Wednesday, Apr 25, 2018
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To your health

A new report ranks Ohio a dreadful 47th among the states in “health value” — how healthy Ohioans are in relation to the amount we spend on medical care. That dismal performance suggests the challenges the state faces in curbing the cost of, and broadening access to, health care while maintaining its quality.

Achieving these goals will require greater public investment in cost-saving preventive care. Ohioans also need to take greater personal responsibility for improving their health.

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The health value “dashboard” compiled by the Health Policy Institute of Ohio notes that just 10 states spend more per person than ours does on health care; that measure includes spending by government, employers, and consumers. Spending on the state’s Medicare program for elderly and disabled Ohioans is especially high compared with that in other states, largely because of avoidable patient visits to hospital emergency rooms, the report says.

Yet for all that spending, the study also concludes that only 10 states are less healthy overall than Ohio, measured by life-spans, physical and mental illnesses, and risky behavior such as smoking, drinking, and lack of exercise.

That combination of high medical costs and bad health outcomes is detrimental to Ohio’s economy as well as its well-being. Both halves of the equation — the money side and the results side — demand to be addressed.

According to the study, Ohio ranks dead last in public-health and prevention measures. State budget cuts during the Great Recession took their toll on the number of state and local public-health workers. Those reductions need to be restored.

Ohio does especially badly in getting children immunized and on spending on tobacco prevention and control efforts and emergency preparedness, the report says. The infant death rate, especially among minority babies, too often approaches third-world levels. Our outdoor air quality remains among the worst of any state.

The report also identifies a need to broaden access to drug-abuse treatment across the state. As Gov. John Kasich prepares his new two-year state budget, these investments require attention.

But Governor Kasich already has taken important steps that the General Assembly now must support. He has expanded Ohio’s Medicaid program of low-income health insurance under the federal Affordable Care Act, extending coverage to nearly 450,000 more working-poor Ohioans, including 25,000 in Lucas County. 

That initiative is saving Ohioans money on costly emergency-room care. As the governor observes, it also is saving lives by encouraging preventive care. State lawmakers must reauthorize the expansion this year; there will be no excuse for partisan or ideological refusal to do so.

Similarly, the Republican governor is expected to resume his call for an increase in Ohio’s cigarette tax; at $1.25 a pack, that tax is in the middle of state tax rates. A higher levy would curb smoking, especially among young people. It also would produce revenue that would enable the state to improve its unacceptable performance on tobacco prevention.

The anti-government, anti-tax, pro-special interest extremism of GOP lawmakers who run the General Assembly must defer to improving Ohioans’ health and saving lives. The new report offers a blueprint for doing that.

But it isn’t just the responsibility of government to make Ohioans healthier and more productive. If we continue to eat, drink, smoke, and use recreational drugs to greater excess than Americans in other states do, and spurn the treadmill or the trail in favor of the recliner, the most gold-plated health insurance isn’t going to do us much good.

The report notes that Ohio ranks near the top in the percentage of its adults who smoke, and of children exposed to secondhand smoke in their homes. Such things are as much a matter of individual responsibility, or its absence, as of inadequate public policy.

The health value dashboard cogently summarizes Ohio’s health deficiencies, and suggests ways to resolve them. What’s needed now is the individual and collective will to act effectively.

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