Friday, August 8, 2008

Keeping Massachusetts in Perspective: Look at the Map

For those frustrated with how hard it is to change things, it can pe useful to take the "long" view, as the Commonwealth Fund in this map. Overall, Massachusetts ranks fourth in the country in "Child Health Systems".  Sounds pretty good, doesn't it?   But the nice thing about the map is that, if you click on the state, it gives you the details.  Remember the details?  Where the devil lives?  This allows you to see that the fact that we are doing well doesn't mean that there isn't still work to do.
So when you click on the "printable version of the Massachusetts data, you get a table with the indicators that the are using.  Our infant mortality is #7 in the country (not bad), but we have a high percentage of children at risk of developmental delay.  What's that about?  Are we saving preemies, or do our services attract families with high levels of need?  Don't know.  We do well on access:  only 5.6 percent of our children are uninsured, and 93% of family below 200% of FPL are insured.  The big one, to me, is our access to specialists:  We were the best in the country, with 86.5 % over children with special needs able to access speciality care.   All of these thing bode well for children in Massachusetts.

And yet.....

We are THE most expensive health care market in America at $6,683 per captita, and we have one of the the highest costs of insurance in the country ($11,435 per year).  It is sad to see that, at best, 22.8% of families report that they cannot access needed behavioral health services (32.4% in Massachusetts, making us #8 in the country).   Only 60% of our families (#3 in the country) report that they have a medical home.  Our needs reflect national needs-  we need access to medical homes, behavioral health services and we need to do something about the everrising costs of health care.  This suggests that our efforts to improve, in these areas represent the right focus for our state. 

When you are number 4, you have to try harder.

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