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Health-care status quo hurts insured as well as uninsured, says Sebelius

This article first appeared in the St. Louis Beacon, June 26, 2009 - The quality of health care in Missouri is just "average," according to a report released today by Health and Human Services Secretary Kathleen Sebelius. Illinois, though, fares worse; the quality of its health care is rated "weak" in the same report.

In releasing the data on all 50 states and holding a conference call with reporters, Sebelius was part of a push by the Obama administration to reframe the debate over health care. Rather than focusing solely on the rising number of uninsured Americans, the administration is trying to personalize health care as a pocketbook issue -- one that hurts the insured as well as the uninsured.

The study said both Missourians and Illinoisans "know that inaction is not an option. Sky-rocketing health-care costs are hurting families, forcing businesses to cut or drop health benefits and straining budgets. Millions are paying more for less. Families and businesses" in both states "deserve better."

For example, since 2000, the average cost of family health premiums have risen 92 percent in Missouri and 89 percent in Illinois. These costs, says the report, are straining household budgets, with 20 percent of middle-class families in Missouri and 22 percent of those in Illinois now spending more than 10 percent of their household incomes on health care.

Roughly 3.5 million Missourians get health insurance on the job where family premiums average $12,925 or about the annual earning of a full-time minimum wage job. In Illinois, the study said about 8.1 million residents get health insurance on the job where family premiums average $13,631.

Not surprisingly, high costs are keeping people from getting health care: 15 percent of Missourians and 13 percent of Illinoisans report that they didn't visit doctors due to high costs. Sebelius noted that such problems of access and costs are common in all the states.

It's not just individuals and families who are burdened by health-care costs, said Sebelius. Small businesses, the "backbone of our economic system," are big losers under current health-care rules.

"They don't have the volume to leverage discounts and don't get to keep and attract the best employees because employees follow health care," Sebelius said. "While over 60 percent of small business owners as recently as five years ago provided coverage," the figure is now down to 38 percent.

The House's health insurance bill "offers a lot to small business owners," she added, including a plan to do away with the pre-existing condition clause that causes costs to skyrocket for small business owners.

Sebelius emphasized that the any solution to the health-care crisis would have to be "uniquely American,'' since no other nation delivers health care to the general working public like the U.S. does, with a largely privately system.

"We need an American solution," she said, but added that Washington had "a lot to learn" about strategies to contain health-care costs from other countries that spend less and provide better care.

Sebelius also said that Obama wanted a public option, one that would compete with private insurers and help to contain costs. Because health care affects everyone, Obama is working toward a bipartisan bill.

The snapshots of health care released today show that health coverage is increasingly out of reach in both Missouri and Illinois. The report says employer coverage dropped to 61 percent from 69 percent in Missouri between 2000 and 2007. In Illinois, the coverage dropped to 64 percent from 67 percent during the same period.

The study also said Missouri and Illinois should place more emphasis on prevention, noting, for example, that 14 percent of children in Missouri were obsese; 23 percent of women over age 50 have not had mammograms in the past two years; and 39 percent of men over age 50 have never received a colorectal cancer screening.

In Illinois, the study said, 21 percent of children were obese, 22 percent of women over 50 hadn't had mammograms in the past two years, and 41 percent of men over age 50 have never had a colorectal cancer screening.

Just recently, Washington lawmakers concluded that the equivalent of a universal health insurance system would cost $1 trillion over the next decade.

In spite of the costs and differences between Democrats and Republicans, Sebelius said she was confident the parties would reach agreement on a bill this year.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.