Michigan

Michigan spends billions on healthcare and the bill keeps going up.

• Michigan spent around $51 billion on health care in 2004.[1] Michigan’s healthcare bill keeps going up, at a 6% average annual increase between 1991 and 2004.[2]
• Michigan spent $5,058 (2004) per capita on healthcare, more than twice the nation’s average per capita spending on food ($2,207).[3]
• Between 2001 and 2005, family premiums in Michigan increased 33.3%, while median earnings of people purchasing family coverage decreased by 5.4%.[4]
• People who buy health insurance through their small business (between two and fifty employees) cannot be excluded due to health condition and the state has issued some cost protections for premium rates.[5]
• The self-employed and people who must buy individual policies have few protections. Although people with preexisting conditions can enroll in an HMO during a one month open enrollment period, there are no restrictions on the price of coverage. Blue Cross Blue Shield accepts all applicants and cannot increase the price based on health condition but can increase the price for other reasons.[6]

Patients in Michigan receive good hospital and home healthcare according to standardized quality measures.

• Heart patients are given necessary treatments and procedures that stabilize heart attacks at higher rates than elsewhere nationally.[7]
• Michigan hospitals provide heart and respiratory patients, and those undergoing surgery, appropriately timed medications at higher rates than average nationally.[8]
• Fewer heart and respiratory patients in Michigan die in the hospital as a result of their illness compared to the national average (deaths per 1,000 admissions).[9]
• People getting home healthcare in Michigan take their oral medicines correctly, improve their ability to perform daily activities, and have less shortness of breath and less incontinence compared to national averages. Fewer have to be admitted to the hospital.[10]
• Nursing home patients aren’t as fortunate. Higher percentages of nursing home residents in Michigan spend most of their time bedridden or in a chair, and fewer of them receive flu or respiratory vaccines, compared to the average in other states.[11]
• Although Michigan law does not require hospitals to disclosure their infection rates, the state’s hospitals came together under the "Keystone Project" to systematically tackle reducing blood stream infections in intensive care units. After a year and a half of using a checklist to reinforce consistent use of infection control practices when inserting IVs into patients, on average these hospitals reduced these infections from 7.7 per 1,000 days of catheter usage to 1.4 per 1,000 days.[12]

But too many patients in Michigan are injured by unsafe care.

• Although the true number of patients harmed by medical errors in each state is a well-kept secret, the Institute of Medicine estimates as many as 98,000 Americans die from these preventable mistakes each year. These errors range from giving the wrong medication to doing surgery on the wrong part of the body, transfusion errors and more.[13]

Michigan faces healthcare challenges with chronic disease and maternal health, but the state is making progress in children’s health insurance coverage.

• Michigan had a higher incidence of cancer than the rest of the nation (497 per 100,000 people in Michigan compared to 460 nationwide) in 2003.[14]
• People in Michigan died of heart disease at a higher rate than the average in other states (234 per 100,000 Michigan residents compared to 217 nationwide).[15]
• Michigan has a much higher rate of asthma patient admissions for children, adults, and seniors (per 100,000 people) compared to the average national rate. For example, 174 Michigan children are admitted per 100,000 people compared to 132 children per 100,000 people nationwide.[16]
• Although a higher percentage of mothers in Michigan received early prenatal care, infants and mothers died in birth at a higher rate than the national average.[17]
• 10% of Michigan residents (about 1 million people) remain uninsured.[18]
• According to a May 2008 report by the Commonwealth Fund, Michigan is one of the top performing states for quality and access in children’s healthcare. 5% of Michigan children are uninsured compared to 12% uninsured children nationwide.[19]

Footnotes:

[1] http://www.statehealthfacts.org/profileind.jsp?ind=592&cat=5&rgn=24

[2] http://www.statehealthfacts.org/profileind.jsp?ind=595&cat=5&rgn=24

[3] http://www.statehealthfacts.org/profileind.jsp?ind=596&cat=5&rgn=24;http://www.foodnavigator-usa.com/news/printNewsBis.asp?id=75043

[4] http://www.rwjf.org/files/research/042508ctuwfinalembargoed.pdf

[5] http://www.statehealthfacts.org/profileind.jsp?cat=7&sub=86&rgn=24

[6] http://www.statehealthfacts.org/profileind.jsp?cat=7&sub=87&rgn=24; http://healthinsuranceinfo.net/getinsured/michigan/a-summary-of-your-protections/how-am-i-protected/

[7] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=MI&level=2&region=0&compGroup=N

[8] Ibid 7; http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=MI&level=5&region=0&compGroup=N

[9] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=MI&level=5&region=0&compGroup=N

[10] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=MI&level=4&region=0&compGroup=N

[11] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=MI&level=6&region=0&compGroup=N

[12] http://www.boston.com/news/local/articles/2007/01/11/state_seeks_to_cut_hospital_acquired_infection_rates/

[13] Institute of Medicine, To Err is Human, Kohn, Linda, Corrigan and Donaldson, 2000, pp.26, 35.

[14] http://www.statehealthfacts.org/profileind.jsp?cat=2&sub=21&rgn=24

[15] http://www.statehealthfacts.org/profileind.jsp?cat=2&sub=23&rgn=24

[16] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=MI&level=18&region=0&compGroup=N

[17] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=MI&level=17&region=0&compGroup=N Reflects 2004 data. 7.6 infant deaths per 100,000 in Michigan compared to 6.6 infant deaths per 100,000 for the national average; 39 maternal deaths in Michigan compared to 14 maternal deaths on average in other states.

[18] http://www.statehealthfacts.org/profileind.jsp?cat=3&sub=39&rgn=24

[19] http://www.washingtonpost.com/wp-dyn/content/article/2008/05/28/AR2008052800973.html; The Commonwealth Fund report focuses on 13 performance indicators of access, quality, costs, equity, and the potential to lead healthy lives: http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=687113; http://www.statehealthfacts.org/profileind.jsp?cat=3&sub=39&rgn=24