Unhealthy Indiana

Yesterday, the IBJ reported the latest data on public health indicators, under a headline that telegraphed the results: “Indiana public health continues to slide.”

When the most recent data is compared to previous studies, it becomes quite clear that Hoosiers are moving in the wrong direction. We are fatter, more sedentary, more diabetic. Hoosiers smoke more than citizens elsewhere, and more of our babies die in infancy.

Not exactly a distinction we would choose.

Furthermore, since our policymakers seem to care a lot more about money than about Hoosier health and well-being, it may be useful to point out that poor health drives up costs. As the IBJ pointed out, Indiana employers spend more per worker on healthcare than employers elsewhere in the country. And that doesn’t include the costs of sick days or reduced productivity as a consequence of health issues. (Forgive me for an indelicate observation: Indiana legislators determined to keep business taxes low don’t seem to understand that the added costs incurred by reason of an unhealthy workforce are just as much a part of business overhead as state income or property taxes.)

No–true to our Hoosier Heritage, which is nothing if not shortsighted–State government is perfectly content to shift health costs to employers, and keep Indiana’s public health spending low. And it is low. In 2012, Indiana ranked 49th out of 50 states in per person spending on public health, despite the fact that preventative public health measures like immunization and screenings demonstrably and dramatically lower overall health costs.

To add insult to injury, Governor Pence has signaled that he will not expand Medicaid in order to participate in the Affordable Care Act, aka “Obamacare.” As I have previously noted, there is no rational basis for that decision; it rests entirely upon a perceived political need to pander to a rabid GOP base motivated solely by an unreasoning hatred of President Obama and anything he supports.

If Indiana opts to participate, an estimated 450,000 Hoosiers would benefit. And here’s the kicker: if Indiana does participate, the federal government will pay all the costs for the first three years. The state’s portion would then phase in gradually, topping out  at 10% in 2020.

And if we don’t participate? Well, poor people have this pesky habit of getting sick anyway. And we already pay to treat them–frequently, in the least cost-effective way, when they appear at hospital emergency rooms. When uninsured folks are treated there, the costs of their un-reimbursed care drives up the premiums of those with insurance. If the hospital is public, our taxes go up. If the hospitals still can’t recover their costs, they cut healthcare workers or reduce services. The 10% Indiana would eventually have to pay to cover far more people is unlikely to be more than we are actually paying now in a variety of ways–it would just be more visible and much more cost-effective.

Indiana certainly wouldn’t want to do something that was actually cost-effective.


  1. The methodology behind those “healthy” or “most obese” or “happy” or “sad” state/city studies is always dubious at best. The problem is the media doesn’t look at the methodology, they only look at the rankings.

  2. Look around you on all city streets, while shopping in any store, watch people in the background of news reports, look at our police officers – including the Chief – watch news films taken in schools and see the condition of too many teachers and students, look at hospital staff on all levels. How many are obese or borderline? Do they look healthy? How many of your neighbors do you see walking the neighborhood? How many chldren do you see outside playing games, riding bikes, roller skating or doing anything active. When was the last time you walked further than to and from your car? No one should be surprised at the IBJ article listing Indiana at the bottom of the list of healthy states. I am 76 years old, deaf and disabled but I walk 16 blocks each morning and 8 blocks each afternoon – using my 4-wheeled walker. Do I want to do this each day – not always but I feel better at the end of the day when I get off my butt and do it. I live on a low fixed income but my fridge holds fruits and vegetables, my freezer has mostly chicken in the meat section and I use my George Foreman grill to cook most meats. It doesn’t take wealth to maintain health; it does take thinking, planning and doing a little extra work to do what we all know is healthy living…and it is cheaper than frequent illnesses, medical bills and funerals.

  3. The depth of the Republican hatred for our president know no bounds. The situation you lay out is so stupid it is breathtaking. At what point is the revolution starting?
    Wis is in the running for stupid too:
    The Gov Walker brain trust turned down 3/4 BILLION DOLLARS to upgrate the train system.
    It would have been an amazing project
    But he receives a lot of campaign cash from the road builders
    SO….the 750,000,000.00 was turned down
    Hows that for stupid?
    Hate filled people do really odd things

  4. But let’s not forget the mantra of ex-Gov. Daniels and current Gov. Pence: ” Indiana is the fiscal envy of the nation.”

  5. Gov. Pence and his cohorts in the legislature put adhering to their political philosophy above the health and welfare of children, the poor and the elderly. He talks about accepting personal responsibility, which is a great concept. If you are sick, try it and see what happens. If you call a physician’s office, you will probably get a choice of numbers to press to talk to different people, none of who will answer the phone but will ask you to leave a message and will return your call. It may be 48 to 72 hours before they do. So you go to the emergency room out of desperation. Try shopping for a scan. You may get a cheaper scan but when the doctor sees the results, you may be told that they did not use the procedure he prefers so he cannot use the results.

    All citizens deserve health care. Other countries are able to provide health care more effectively and at a lower cost than can be obtained in the United States. Now is the time to solve this problem and Pence does not have the right solution

  6. I certainly didn’t mean to sound like Gov. Pence with my previous diatribe; healthcare coverage for all is vital in this state and this country. I was trying to make the point that people need to take responsibiity for their own physical condition and maintain their health and that of their family members. Of course, health care coverage is necessary and for far too long we have been paying the price for those who could not afford – or just refuse to pay for – health care. Rising medical care and prescription costs are only a few of the results of our indebtedness to pay for others. My recent 2-day in-patient hospital care resulting in a bill of over $20,000 is a good example of NOT extending Medicaid and refusing benefits of the Affordable Care Act – no matter what name you choose to use for this enacted bill or how many times Congress votes to repeal it.

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