Report indicates worsening state of affairs in accessing health care

Debbie Souders 38,  and her daughter Brandie Roberts 19, try to sleep at 4:30 a.m. Friday, Sept. 24, 2010, in the parking lot of the Douglas County Dental Clinic, 316 Maine. They were in line for the third annual Free Dental Day, a day when the clinic provides care for free for the first 70 people in line.

Debbie Souders 38, and her daughter Brandie Roberts 19, try to sleep at 4:30 a.m. Friday, Sept. 24, 2010, in the parking lot of the Douglas County Dental Clinic, 316 Maine. They were in line for the third annual Free Dental Day, a day when the clinic provides care for free for the first 70 people in line. by Richard Gwin

The ability for adults to access basic health care services has declined in nearly every state, including Kansas, during the last decade, according to a new report released early today by the Robert Wood Johnson Foundation.

Researchers at the Urban Institute looked at three indicators for adults ages 19 to 64:

• having a routine checkup during the previous year.

• having a dental visit during the previous year.

• having unmet medical needs because of cost.

Researchers found a decline across all three measures between 2000 and 2010. Nationally, they found:

• 63 percent — had a routine checkup in 2010, down from 68 percent in 2000. In Kansas, it was 66 percent down from 68 percent.

• 65 percent — had a dental visit, down from 69 percent. In Kansas, it was 68 percent, down from 72 percent.

• 18 percent — had unmet medical needs because of cost, up from 12 percent. In Kansas, it was 15 percent, up from 10 percent.

It’s the first report to provide a state-by-state look at changes in access and the first to compare access in every state for those with insurance to those without insurance.

“Our study shows that the uninsured experience substantially worse access to care relative to the insured in all states,” said Genevieve Kenney, the study’s lead author. “This indicates that the health care safety net is not acting as an effective substitute for health insurance coverage when it comes to providing basic health care to the uninsured.”

Among the uninsured in Kansas in 2010:

• 42 — percent had a routine checkup.

• 37 — percent had dental visit.

• 45 — percent had unmet medical needs because of costs.

When people don’t have access to preventive care, the consequences can be devastating financially and physically, Kenney said.

“The kinds of things that would concern me are whether it leads to later diagnosis of health problems, and that could have morbidity and mortality implications,” she said. “It also could lead to higher costs down the road.”

For people who don’t access dental care, she fears there could be unnecessary pain and suffering.

“Oral health issues are of particular interest because so many of them are preventable and yet, if not attended to, they can lead to severe problems,” she said. “There’s an economic dimension to that too. If you have real problems with your teeth, it can mean you may have a harder time in the job market.”

The results of the report were no surprise to Julie Branstrom, executive director of Douglas County Dental Clinic, which provides dental care for low-income residents who don’t have private insurance. She said the wait for a nonemergency appointment is mid-July.

“We continue to see an increase in the number of uninsured adults and especially the number of adults who qualify for the services at our lowest fee level,” she said. The clinic charges patients on a sliding scale based on household income. The lowest fee level is 100 percent of the federal poverty level, which is $10,890 annual income for an individual or $22,350 for a family of four.

She said the clinic is struggling to meet the growing needs because the clinic has received no increase in state funding and it lost $8,000 in United Way of Douglas County funding this year.

“I am trying to figure out a way to pay the bills and keep the doors open,” she said.

In 2011, the clinic had 6,816 patient visits. It provided care for 3,676 patients and of those 1,466 were uninsured.

Inadequate access to dental services was among the top challenges unveiled in a 38-page Community Health Assessment released last week by the Lawrence-Douglas County Health Department. It found one in five residents had not seen a dentist in the past year. Insufficient access to health care also was mentioned. Thirty-five percent of adults said they had not had a checkup in the past year.

Kenney thinks a number of factors are causing the decline in access to care. Among them:

• A decline in health insurance coverage.

• For those with insurance, there have been rising costs for co-payments and premiums.

• For those with Medicaid coverage, she thinks there is a lack of providers because more people are qualifying for services.

• For the uninsured, there has been a lack of funding for safety net clinics and therefore, they can’t keep up with demand.

“It’s interesting because we know some states have been more aggressive about trying to support the safety net clinics to provide direct care to the uninsured, but it looks like that just doesn’t substitute for having health insurance coverage,” Kenney said.

Tagged: dental care, primary care, safety net clinics, Douglas County Dental Clinic, Robert Wood Johnson Foundation, Lawrence-Douglas County Health Department

Comments

attorney1776 2 years, 2 months ago

To present this article in proper context, perhaps it's good to mention the fact that the Robert Wood Johnson Foundation and the Urban Institute are both extremely left-leaning politically biased organizations with their own agendas (pro-ObamaCare and big government) to promote and validate through non-independent "studies".

That being said, both sides do these kind of slanted, biased studies-- as a reporter and newspaper, you would think true journalists would present both sides of the issues discussed for the reading public to form their own opinions based on a fair presentation of facts regardless of the commendable community service offered by our local organizations.

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overthemoon 2 years, 2 months ago

Can you recommend other studies or organizations which you would find acceptable as sources on this issue?

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overthemoon 2 years, 2 months ago

Can you recommend other studies or organizations which you would find acceptable as sources on this issue?

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overthemoon 2 years, 2 months ago

Can you recommend other studies or organizations which you would find acceptable as sources on this issue?

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John Kyle 2 years, 2 months ago

So you're saying the numbers are wrong? Do you have any facts other than your own fear of 'liberals'.

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jimmyjms 2 years, 2 months ago

Attorney1776:

According to the article, the research was done by the Urban Institute, which is a nonpartisan think tank.

Secondly, what is the "other side" of the issue? Eff 'em?

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attorney1776 2 years, 2 months ago

"The Institute was established in 1968 by the Lyndon B. Johnson administration to study the nation’s urban problems and evaluate the Great Society initiatives embodied in more than 400 laws passed in the prior four years. Johnson hand-selected well-known economists and civic leaders to create the non-partisan, independent research organization. Their ranks included Kermit Gordon, McGeorge Bundy, Irwin Miller, Arjay Miller, Richard Neustadt, Cyrus Vance, and Robert McNamara.[3] William Gorham, former Assistant Secretary for Health, Education and Welfare, was selected as its first president and served from 1968-2000."

"Gradually, the Institute's research and funding base broadened. Today, federal government contracts provide about 55% of the Institute’s operating funds, foundations another 34%, and state and local governments and private individuals the rest.[4] Some of the Institute’s more than 100 private sponsors and funders include The Atlantic Philanthropies, the Annie E. Casey Foundation, the Ford Foundation, the Robert Wood Johnson Foundation, the Henry J. Kaiser Family Foundation, the Charles Stewart Mott Foundation, and the Rockefeller Foundation."

I simply don't read a make-up here of non-partisan participants or foundations. Each and every one is a liberal, left-leaning person or organization. There is no harm, no foul in that, but the journalist should point that out. As such it makes the data and article information biased towards their point of view.

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Enlightenment 2 years, 2 months ago

So what you've pointed out is that "liberals" are compassionate and caring individuals concerned about the health and well being of others.

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OldEnuf2BYurDad 2 years, 2 months ago

I voted for McCain.

I voted for Brownback.

My wife and I both work. We both have advanced degrees and professional positions.

We have what most would call "good" health insurance by most standards (BCBS).

Yet... I spent $200 on prescriptions last week and my co-pays for doctor visits are more today than I used to pay for an uninsured visit 20 years ago (by about $10).

We make $90K+ per year, yet we cannot afford anything better than our old cars and 1,100 sq. ft. home. We have a number of issues effecting those problems, but medical expenses are at the top of our list of debt issues.

And by today's standards, we are living "well".

FACT: 48% of Americans are either impoverished or considered low-class (economically).

This conservative - using common sense - is sure that something is broken.

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attorney1776 2 years, 2 months ago

This is the "Comment" section. I am commenting on unbiased reporting and presenting "all" the underlying facts necessary to allow the reading public the opportunity to formulate their own options based on presentation of all issues regarding the topic or issue.

It's the journalist's obligation to provide you with contridictory or opposing data, not mine.

If you would care to follow the guidleines for the "Comment" section and discuss the issues brought up, please do.

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KEITHMILES05 2 years, 2 months ago

A huge, huuge problem today with Americans is laziness and obesity. It is absolutely disgusting to see fat people eating food to promote their fat and sitting around watching TV instead of exercising and eating healthy. Many people have health issues of their own making. No public monies need to subsidize them.

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jimmyjms 2 years, 2 months ago

The Urban Institue is "liberal" in the sense that they study issues facing the poor, the handicapped, and minorities, constituencies that are no consequence to conservatives. Their research, however, is beyond reproach: UI has been praised by the Heritage Foundation and the American Enterprise Institute.

If you're going to claim bias, it is incumbent on you to provide a factual assertion of bias. Just crying "they're liberals!" does nothing to further the conversation.

I notice you didn't care to explain what the "other side" of the issue was.

Finally, I'm pretty sure no one made you the boss of the comments section. Calm down.

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attorney1776 2 years, 2 months ago

Kindly read my post above again---

"It's the journalist's obligation to provide you with contridictory or opposing data, not mine." This is how good opinions are formulated and good journalism is performed.

Perhaps you can provide the Heritage Foundation and the American Enterprise Institute quotes for their praise? I would be open to reading their opinions directly, not 3rd hand.

Your commenting on my posts and opinions. If you care to diverge the topic, you can be the "boss" of your issue or comment.

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ldchealth 2 years, 2 months ago

The report from the RWJF may be surprising to some. As mentioned in the article, Douglas County is not immune to these issues.

If you'd like to be a part of the effort to solve these problems, please attend one of the upcoming community forums. The recently released community health assessment will be presented at the forums and the problem solving will begin. We need the public's input, however, to go forward.

Check out this link for more info: http://wellcommons.com/groups/lawrenc...

The first forum is in Lawrence tomorrow at the Community Health Facility. Hope to see you there!

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jimmyjms 2 years, 2 months ago

Attorney, I hope the irony of you asking me to post a link to the aforementioned info when your entire argument against UI above is similarly unsourced is not lost on you.

So...you first.

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attorney1776 2 years, 2 months ago

I've already done so. Perhaps you didn't read my postings completely.

Claiming my references are "un-sourced" would come as a surprise to UI, I'm suspect.

The history, make up and mission of the Urban Institute is taken verbatim from their own website and literature.

I will wait for your sourcing information to appear here now. Thanks.

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Centerville 2 years, 2 months ago

It doesn't help that ZippyCare takes $500 billion out of Medicare, which is being done by lowering reimbursement rates which leads to (surprise!) physicians getting out of the Medicare business.

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JayhawksandHerd 2 years, 2 months ago

Hey, you know what's fun? Being 31 years old and dealing with psoriatic arthritis. Even with my insurance, the newest meds on the market are $2,500 a pop, meaning the only option I can afford is methotrexate - you know, the old-school cancer drug that at one time was given as a lethal dose in order to kill the most rapidly dividing cells, with the antidote administered 24 hours later. Sweet!

Of course, if I wasn't so fat an lazy, I wouldn't have this problem. Except that I'm a vegetarian who exercises daily and maintains a healthy body weight. Go figure.

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jmadison 2 years, 2 months ago

From Medline Plus sponsored by the US National Library of Medicine, National Institutes of Health current recommendations for health screening for males 18-39 is an exam every two years: http://www.nlm.nih.gov/medlineplus/ency/article/007464.htm

Very similar recommendations for females 18-39 http://www.nlm.nih.gov/medlineplus/ency/article/007462.htm

Recommendations for other ages may be found at the medline site.

The NIH recommendation appears to be at odds with the assumptions of an an annual exam as cited in the study.

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