Montana

Montana spends billions on healthcare, and the bill keeps going up.

Montana spent around $4.7 billion on health care in 2004. Montana’s healthcare bill keeps going up, at a 7% average annual increase between 1991 and 2004.[1]
Montana spent $5,080 (2004) per capita on healthcare, more than twice the nation’s average per capita spending on food ($2,207).[2]
Between 2002 and 2005, family premiums in Montana increased 20.2%, while median earnings of people purchasing family coverage decreased by 2.1%.[3]
Whereas 56% of private businesses across the nation offer health insurance to employees, only 40% of private businesses in Montana offer coverage.[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. They may pay very high rates or be permanently denied due to health status or other factors.[6]
The state has a high risk pool program for people who can’t get insurance through their employer or the individual market, but it is likely to be unaffordable for many, with a monthly premium of $686 and an annual deductible of $1,000. Except for people who were continuously covered for 18 months prior to joining the pool, the plan excludes coverage for pre-existing conditions for 12 months.[7]

Patients in Montana receive quality care in most settings, according to standardized quality measures.

A higher share of heart patients in Montana are given necessary medical treatments that help stabilize heart attacks compared to the average across the country.[8]
A higher percentage of patients undergoing surgery in Montana hospitals receive appropriately timed antibiotic treatment compared to other states, which reduces the risk of contracting an infection.[9]
Pneumonia patients in Montana hospitals receive antibiotics within four hours of arrival at a higher rate than the national average (84% of patients in Montana compared to 76% nationwide).[10]
A higher percentage of mothers in Montana begin early prenatal care (83%) compared to the average in other states (78%).[11]
However, people living in Montana nursing homes experience moderate to severe pain at higher rates than average nationally. A higher percentage of long-stay residents have had a catheter left in their bladder too long, which put them at a high risk of infection.[12]
Compared to other states, a lower percentage of home healthcare patients in Montana get better at taking their oral medicines correctly and a higher percentage have urinary incontinence.[13]

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

Montana has no hospital infection reporting law. No hospital infection rates are available.
Although the true number of patients harmed by medical errors in each state is neither collected nor reported to the public, the Institute of Medicine estimates as many as 98,000 Americans die from these preventable mistakes each year. These errors range from doing surgery on the wrong part of the body to serious bed sores to getting the wrong dose of medication.[14]
Preventable medical errors that occur during or after surgery cause 10 percent of surgery-related deaths and may cost employers nearly $1.5 billion a year.[15]

Montana faces healthcare challenges.

17% of Montanans (about 152,250 people) remain uninsured, higher than the average in other states (16%).[16]
Approximately 37,000 children in Montana don’t have health coverage. The state ranks 45th in percentage of uninsured children, with 14.3% uninsured children compared to an all state median rate of 9.1.[17]

Footnotes:

[9] Ibid 8: 86% of all adult surgery patients received appropriate timing of antibiotics compared to 76% on average nationally.

[10] Ibid 8.