Health care jobs carry CT’s employment outlook

The current issue of The CT Economic Digest, from the CT Dept. of Labor, reports that between December and April both CT and the US have had four consecutive months of contracting employment. (Apparently this isn’t bad enough for economists to label it a recession yet.) Historically CT’s employment downturns average 24 months while US cycles only average 13.8 months. However the good news for CT is health care. CT created 6,233 new health care jobs in the first quarter of 2008, compared to last year. Most of the gains were at hospitals, nursing and residential care facilities and in ambulatory care. Just behind health care in job creation, government added 4,367 jobs. Job losses were worst in the manufacturing sector. Predictions are that overall CT job losses will continue into next year, but that health care will create 7,970 new jobs between the fourth quarters of 2007 to 2009.
Ellen Andrews

Governor vetoes pooling bill

Today Governor Rell vetoed HB-5536, An Act Establishing the Connecticut Healthcare Partnership. While she applauded the intent of the bill, to reduce health care costs for municipalities, nonprofits and small businesses by pooling them with state employees, she is concerned about potential costs to the state. She also cited legal problems with the bill, doubts about estimated savings for municipalities, and concerns that the bill does not address the problem of Connecticut’s uninsured. She called on legislators to work with her office to refine the concept next year.
Ellen Andrews

Houston to hire nurses as ER alternative for non-urgent care

In 2006 Harris County, which includes Houston, spent $50 million on emergency room care for patients with problems that could have been treated in a doctor’s office, according to the Houston Chronicle. The city wants to hire “tele-nurses” to work with 911 dispatchers offering first aid advice or help getting an appointment for care with a doctor or clinic for callers who do not have a true emergency. The Director of Emergency Medical Services says that many patients call 911 because they have no insurance, no transportation to the hospital or they have insurance but can’t get after hours care or cannot judge how serious a problem may be. “The whole idea is to educate people, help them get self-care when appropriate,” according to the Executive Director of the Harris County Health Alliance. “It’s just about getting these folks to connect to what we call a ‘medical home,’ a regular source of care.” Ambulance rides cost $415 each plus $7.50 per mile and ambulances responding to non-urgent problems take vital resources away from true emergencies. Richmond, VA has a similar program.
Ellen Andrews

For-profit Medicaid managed care plans provide less care according to study, Implications for return to capitation in HUSKY

A study published in Medical Care Research and Review in April found that access to health care is lower for Medicaid managed care members in for-profit HMOs than for those enrolled in nonprofit plans. The author found that members of for-profit plans were 14% less likely to have had a doctor visit in the last year (statistically significant) and 6% more likely to report an unmet need for medical care and for prescription drugs (not significant). More research needs to be done. However, this study does suggest that moving 337,181 HUSKY consumers back to capitated HMOs, including two for-profit companies, on July 1st is unwise. Another reason to delay re-contracting HUSKY.
Ellen Andrews

International study finds health inequities are about more than health coverage; editorial explores implications for US Presidential elections

A new study published today in JAMA compares health inequities across 22 European countries. Not surprisingly, rates of death and poor health are linked to lower socioeconomic status. However the scale of the disparity varied widely between countries. The authors attribute the variations in part to causes of death due to smoking, alcohol use and access to good quality health care. Interestingly, the variation between countries did not track with the generosity of welfare policies. Southern European countries tend to have less generous and less universal policies than Northern countries, but smaller health inequities, possibly due to healthier diets and lower smoking rates among women. The authors conclude that, while “a reasonable level of social security and public services may be a necessary condition for smaller inequities in health, it is not sufficient.” They suggest that improving educational opportunities, income distribution, healthy behaviors and access to quality health care may be most important. The accompanying editorial links the study to our upcoming Presidential elections. Virtually all of the 22 countries in the study have national health care policies, but wide health inequities remain. “[P]olicies related to preventive social, economic and behavioral interventions might well have a greater effect on reducing disparities than traditional medical interventions, even if as an unintended by-product.” As we’ve hard from states that are implementing “universal” health care reforms, like MA, VT and ME -- it’s not all about insurance.
Ellen Andrews

Massachusetts uninsured cut in half

The results are in. Massachusetts’ comprehensive health care reforms passed in 2006 have led the state’s rate of uninsurance to drop by almost half – from 13% in fall 2006 to 7% a year later. 355,000 more adults in Massachusetts now have affordable coverage– more than the entire uninsured population of Connecticut. The reform law, Chapter 58, included significant Medicaid expansions, subsidized private insurance offerings through an independent, trusted, and transparent resource, insurance market reforms and required individual and employer contributions. A survey published today in Health Affairs also found that under Chapter 58 the number of residents with high out of pocket costs and those reporting having trouble paying medical bills are down. The survey reported an increase in preventive care doctor visits, dental visits, a reduction in the number of adults who did not get needed care in the last year, but unfortunately no drop in ER visits. There was an increase in the number of respondents who had trouble finding a doctor or getting an appointment, but a decrease in the number who reported getting fair or poor care in the past year. 71% of state residents support the reforms. Researchers found no evidence of “crowd out” – employers dropping coverage or benefits in response to Chapter 58 requirements. Among the remaining uninsured adults, most are young and working with incomes below 300% of the federal poverty level. Only 11% have access to health benefits through work and 78% considered getting care through the new state programs. 80% reported that it would be difficult to come up with the cost of coverage, 41% had trouble paying other bills, and almost a third were not aware of the individual mandate. As for that mandate – the Dept. of Revenue reports that 86,000 tax filers paid the penalty ($219 for an individual) for remaining uninsured. Next year that penalty goes up to as much as $912.
Ellen Andrews

New from the Consumer Health Action Network

New materials for consumers from the Consumer Health Action Network:
CT Hospital Free Care and Financial Discount Programs – a compilation of financial assistance policies from CT hospitals
Two new tip sheets – Preparing for a Doctor’s Visit, Help Working with Your Doctor
Latest newsletter – Help to Lower Your Drug Costs

For more help, search our list of over two dozen tip sheets and our newsletter archives

For help accessing health care in CT, call our helpline toll-free 1-888-873-4585 or email information@cthealthpolicy.org