BRIAN HOWEY: Political obstacles for an unhealthy Indiana

2013-10-27T00:00:00Z BRIAN HOWEY: Political obstacles for an unhealthy IndianaBy Brian Howey nwitimes.com
October 27, 2013 12:00 am  • 

As the focus turns from the manufactured shutdown/default crisis in Congress to the disastrous rollout of Obamacare, there is one thing Hoosiers should focus on. Indiana is not a healthy state.

Indiana ranked 41st in total health, according to America's Health Rankings. It was ranked 37th in 2011. In 2000, Indiana's obesity rate was 19.9 percent, ranking 42nd in the U.S. In 2012 it was 30.1 percent. Our smoking rate has gone down from 27 percent in 2000 to 21.2 percent last year, or 1.5 million smokers, but that is still high enough to rank us 44th. In 2001, our diabetes rate was 6 percent. Now it's 9.8 percent, ranking Indiana 33rd. We rank 38th in cardiac heart disease. Indiana is 49th in air pollution at 13.1 micrograms of fine particles per cubic meter.

In the past decade, the percentage of children in poverty more than doubled from 10.8 percent to 23.6 percent of persons under age 18. Some 13.5 percent of our households are "food insecure," according to the U.S. Department of Agriculture. In the past year, the number of infectious disease cases rose from 7.8 to 11.7 cases per 100,000 population.

I've reported this before, but once again, 2.7 million Hoosiers (out of a 6.5 million population) walked into a hospital emergency room last year. Thirty Indiana counties have no obstetrics services. Because of this lack of pre- and post-natal care, Indiana's infant mortality rate is a stunning 7.7 per 1,000 babies, a full percentage above the national average. From 2006 to 2010, according to the Indiana Department of Health, 4,115 Hoosiers died by suicide.

Indiana State Police busted a record 1,726 meth labs in 2012, up from 1,437 in 2011. And we have a prescription drug overdose "epidemic," according to Attorney General Greg Zoeller.

So this resistance to Obamacare is baffling in a public health sense. Politically, it has drawn the most vociferous opposition since the Vietnam War. But from a policy standpoint, at least it is trying to address an overall situation that should induce a "crisis" atmosphere from our public servants.

Unfortunately, many of our public servants, from Gov. Mike Pence, to the congressional delegation, to the Indiana General Assembly, are more concerned about low taxes and the business climate.

State Rep. Ed Clere, the New Albany Republican who heads the House Public Health Committee, was quoted in the Anderson Herald-Bulletin during a health town hall meeting this past week as saying, "It's my party that needs to be convinced, to put it bluntly," on extending Medicaid coverage to an estimated 300,000 to 400,000 Hoosiers who will lack coverage.

The political obstacle is a hatred and loathing for President Barack Obama.

But it is coming at the expense of making wise policy decisions that can impact this crisis.

I'll give you a prime example: Pence's decision to have Indiana opt into the federal health exchange, as opposed to creating one of our own. It was an interesting choice, given Pence (and many other Republicans) view the federal government as inefficient at just about everything it touches.

Kentucky opted for its own state-run exchange, one of 17 states to do so. The Lexington Herald-Leader reported last week that Kentucky's state-run implementation of health care reform — Kynect — has enrolled 15,000, while 272,339 people had visited the site. Kentucky had an uninsured population of 640,000.

Like Indiana, Kentucky is a so-called "red state" with a voracious opposition to Obamacare. Gov. Steve Beshear — a Democrat — has taken a lot of arrows over the exchange. “It's amazing to me that the folks who are challenging that are folks that usually think we don't want the federal government in here," he told WHAS-TV. "We would rather handle our own affairs."

Sen. Joe Donnelly, who has won races for U.S. House and U.S. Senate since he voted for the Affordable Care Act in 2010, told me, "We have over 900,000 uninsured Hoosiers. We have between 300,000 and some say closer to 400,000 who are in that gap that Indiana has no plan for at all right now. This is not meant disrespectfully, but government officials here have said, 'Well, they can go to the emergency room.' Well, that's not much of a health program.”

Donnelly also believes Hoosiers are not being well-served when Indiana opted not to run its own health exchange. Pew Research reported that in the 27 states with federally-run programs — including Indiana — 59 percent are aware of the exchange, compared to 72 percent in states with their own exchanges.

"We always talk about Hoosier common sense and Hoosier hard work and Hoosier exceptionalism," Donnelly said. "If Indiana folks had designed their own exchange, I personally think the Indiana exchange would have been the best in the country. I wish we had had that chance."

At a time when our governor should be having an established dialogue with Hoosiers over the health crisis he rules over, there is silence, and an emphasis on business. "For Indiana, our fiscal integrity is the foundation of our prosperity," Pence told me last summer when I brought up the health challenges we face.

Really, governor? Really?

Brian Howey is publisher of Howey Politics Indiana. Follow him on Twitter @hwypol. The opinions are the writer's.

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