Princess Health and Kentuckians agree regionally on tobacco controls; poll shows wide differences among regions in impact of drug abuse. Princessiccia

Princess Health and Kentuckians agree regionally on tobacco controls; poll shows wide differences among regions in impact of drug abuse. Princessiccia

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Gusty 21:01 Add Comment

By Al Cross
Kentucky Health News

In a state that once had more tobacco farms than any other, Kentuckians in all regions of the state support policies that discourage use of the product, according to the Kentucky Health Issues Poll.

"Such policies could greatly improve Kentucky's overall health," says the Foundation for a Healthy Kentucky, which co-sponsors the poll each fall. It issued a package of reports that broke down a wife range of previously reported poll results on a regional basis.

Kentucky has fewer than 5,000 tobacco farms, down from a high of 60,000 in 1982, but still has one of the nation's highest smoking rates, 26 percent. That leads to an estimated $2 billion in annual health-care costs.

In every region of the state, a majority (ranging from 59 to 70 percent) of people polled said it would be "difficult" or "very difficult" to make the most important change in their personal health behavior, which for most smokers would be to stop smoking.

"Kentucky adults in every region recognize that improving diet, getting more exercise and quitting smoking could help improve personal health, but the changes are difficult," said Susan Zepeda, president and CEO of the foundation. "Policies around these areas could help all Kentuckians improve their personal health."

The policy getting the strongest support in the poll was tobacco-free school campuses, favored by 85 percent statewide. Fewer than a third of Kentucky's school districts have such policies, but enough do to cover almost half the population.

A statewide ban on smoking in workplaces got 66 percent support. Such a ban is unlikely during the administration of Gov. Matt Bevin, who says the issue should be decided locally. About a third of the state's population lives in jurisdictions with comprehensive smoke-free ordinances; another 10 percent or so live in places that have ordinances with varying exceptions.

There was little difference among the five regions in polling on the two issues.

The poll found regional differences in the percentage of Kentucky adults who said they had no insurance, from 18 percent in Western Kentucky to 8 percent in Eastern Kentucky. The statewide uninsured rate reported at the time of the poll was 13 percent. Other surveys have showed the number in the single digits statewide, after expansion of the Medicaid program under federal health reform.

Health reform also provided subsidies for buying insurance, but some consumers have complained about high deductibles and co-payments. In Northern Kentucky, 34 percent of poll respondents said they had difficulties paying their medical bills in the previous 12 months. The figure was 31 percent in Appalachian Kentucky, 30 percent in Greater Louisville, 25 percent in Western Kentucky, and 22 percent in Greater Lexington.

"An increasing number of Kentuckians have health insurance, but many are still delaying or simply can't afford necessary health care," Zepeda said.

Federal health reform was most popular in the Louisville area, at 44 percent support, and least popular in Northern Kentucky, with 33 percent. Generally, the more impact people said reform had on them, the more likely they were to support it. Three of five Northern Kentuckians said they had not been affected by the reforms but only 45 percent in the Louisville area said that.

There are bigger differences in the impact of drug abuse. One-third of Eastern Kentucky residents in the poll reported reported family members or friends struggling with prescription drug abuse, but only 16 percent in Western Kentucky said so.

Heroin use has caused problems for 35 percent of respondents' families and friends in Northern Kentucky, 17 percent in Greater Louisville, 14 percent in Greater Lexington, 10 percent in Eastern Kentucky, and 8 percent in Western Kentucky.

The regional reports for Eastern Kentucky, Greater Lexington, Greater Louisville, Northern Kentucky, and Western Kentucky, and associated news releases, are available at http://healthy-ky.org/news-events/press-releases.

The poll was conducted Sept. 17 through Oct. 7 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,608 adults from throughout Kentucky was interviewed by landlines and cell phones. The statewide poll has a margin of error of plus or minus 2.4 percentage points, but the smaller regional samples have higher error margins. The complete data file, codebook and survey instrument will be posted by June 30 at http://www.oasisdataarchive.org/ with other data files from previous polls.

Princess Health and Poll finds many Kentuckians continue to struggle with cost of health care, though fewer are uninsured and struggling. Princessiccia

Princess Health and Poll finds many Kentuckians continue to struggle with cost of health care, though fewer are uninsured and struggling. Princessiccia

Foundation for a Healthy Kentucky health care costs health insurance health reform Medicaid poll

Gusty 17:21 Add Comment

While having health insurance certainly eases the cost burden of health care, nearly one-third of Kentucky adults struggle to pay their medical bills whether they have health insurance or not, and two in 10 say they often delay or skip needed medical care because of the cost, according to the latest Kentucky Health Issues Poll.

The poll, taken Sept. 17-Oct 7, found that in 28 percent of Kentucky households, someone had trouble paying medical bills in the previous 12 months. This didn't vary much between those with or without insurance, and was about the same as in 2014.

However, fewer Kentucky adults without insurance said they had difficulty paying their medical bills in 2015 than in 2014: down to 31 percent from 47 percent. In 2014, the Patient Protection and Affordable Care Act was fully implemented in Kentucky with expansion of the federal-state Medicaid program to people with incomes up to 138 percent of the federal poverty level.

According to the Kaiser Family Foundation, the average annual out-of-pocket cost per person for health care in the United States in 2014 was $1,036,which includes costs for any expenses not covered by insurance, says the report.

The Kentucky Health Issues Poll also found that 20 percent of Kentucky households did not get the medical care they needed, or delayed care because of the cost, in the past 12 months. This was more common among Kentucky's uninsured (27 percent) than those with insurance (19 percent).

However, these figures were an improvement from 2009, when 58 percent of uninsured Kentucky adults said they delayed or didn't get needed care, and from 2014, when 38 percent said so.

Poorer adults, those eligible for Medicaid, were more likely to forgo health care because they can't afford it; 29 percent of them said they had in the previous year, while only 16 percent of people with higher incomes said so.

"Being able to access medical care and being able to afford that care are two important factors to improve health in Kentucky," Susan Zepeda, CEO of the Foundation for a Healthy Kentucky, said in a news release. "KHIP data indicate that fewer Kentucky adults are delaying medical care. This helps Kentuckians get and stay healthier, getting timely preventive services and early help with management of chronic conditions like diabetes and asthma and with smoking cessation counseling."

The poll was conducted by Institute for Policy Research at the University of Cincinnati and for the foundation and Interact for Health, formerly the Health Foundation of Greater Cincinnati. It surveyed a random sample of 1,608 adults via landline and cell phone, and has a margin of error of plus or minus 2.4 percentage points.

Princess Health and 85 percent of Kentucky adults want schools to be tobacco-free, but only 28 percent of the state's school districts are. Princessiccia

Princess Health and 85 percent of Kentucky adults want schools to be tobacco-free, but only 28 percent of the state's school districts are. Princessiccia

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Gusty 09:32 Add Comment

An overwhelming majority of Kentucky adults, 85 percent, want schools to be tobacco-free, according to the latest Kentucky Health Issues Poll.

But only 28 percent of the state's school districts have "protected students, staff members, teachers and guests from secondhand smoke by enacting 100 percent tobacco-free school policies," says a press release from Interact for Health, which co-sponsored the poll with the Foundation for a Healthy Kentucky. A list of the districts is at www.tobaccofreeschoolsky.org.

"Kentucky ranks 50th, the worst state in the nation, in the percentage of secondary school campuses that prohibit tobacco use in all locations at all times," the release says. "Nationally, 65 percent of schools have such a policy." In Kentucky, such policies are set by local boards of education.

The state's tobacco heritage remains strong. In 2015, 23 percent of Kentucky middle-school students reported trying cigarettes, and 28 percent of high school students said they used cigarettes, cigars, or smokeless tobacco.

The poll found large majorities of smokers, former smokers and non-smokers in favor of tobacco-free campus policies, and support was strong across party lines. The greatest opposition was found among the poor, African Americans, people who haven't gone to college and those who said their general health was fair or poor.

Susan Zepeda, president and CEO of the foundation, said in its news release, "A 100 percent tobacco-free campus policy reduces a young person's exposure to second-hand smoke and allows adults to model tobacco-free lifestyles. Notably, Kentucky smokers understand this important issue. Eighty percent of current smokers favor tobacco-free school policies in their communities."

The Kentucky Health Issues Poll was conducted Sept. 17 through Oct. 7 by the Institute for Policy Research at the University of Cincinnati. The sample of 1,608 adults has an error margin of plus or minus 2.4 percentage points.

Princess Health andFederal agency offers a consumer-friendly website that ranks patients' experiences in your local hospitals .Princessiccia

Princess Health andFederal agency offers a consumer-friendly website that ranks patients' experiences in your local hospitals .Princessiccia

hospitals Medicare Patient Protection and Affordable Care Act poll rankings

Gusty 17:14 Add Comment

Consumers now have access to a website that ranks 3,500 hospitals around the country on patients' experiences to help them choose a hospital and better understand the quality of care participating hospitals offer, according to a Centers for Medicare and Medicaid Services press release.

The 12 star ratings on Hospital Compare are based on 11 of the publicly reported measures from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, and a summary rating for the survey. The survey asks patients questions about nine topics:communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness of the hospital environment, quietness of the hospital environment, and transition of care. This survey information is self-reported by patients and will be updated quarterly.

�The patient experience star ratings will make it easier for consumers to use the information on the Hospital Compare website and spotlight excellence in health care quality,� Dr. Patrick Conway, acting principal deputy administrator for the CMS, said in the release.

Consumers already have access to Medicare star systems to rate nursing homes, dialysis centers, private Medicare Advantage insurance plans and certain situations for physicians and group practices, but are they using it?

Not much, according to a recent Kaiser Family Foundation poll. It found that only 31 percent of those polled had seen any information comparing doctors, hospitals, and health insurance plans in the past 12 months. When asked specifically if they had seen information comparing prices or quality across plans and providers, fewer than 1 in 5 people said they had seen such information, and fewer than one in 10 reported using such information.

CMS said the website helps meet goals of the Patient Protection and Affordable Care Act, which calls for transparent, easily understood and widely available public reporting. The agency also reminds consumers that the site is just one tool to help them make a decision abut which hospital to use, and encourages them to talk to their health-care providers about hospital quality, and to use "multiple factors" when deciding about a hospital, such as clinical outcomes and other publicly reported data that is on the website.

To see the rankings:

• Go to the Hospital Compare website
• Type in your ZIP code, or the name of a particular hospital
• Click on "Search"
• Choose three hospitals, by clicking on the "Add to Compare" button
• Click on "Compare Now," located at the top of the screen
• Click on "Survey of Patients' Experiences"
• Scroll down and view star ranking and additional information results

This is a screen shot of the final screen, with a bar of options to click on.

Princess Health andMost Kentuckians don't think insurance rates should be higher for the obese, but are divided on increasing smokers' rates.Princessiccia

Princess Health andMost Kentuckians don't think insurance rates should be higher for the obese, but are divided on increasing smokers' rates.Princessiccia

Foundation for a Healthy Kentucky health insurance obesity poll smoking tobacco

Gusty 10:51 Add Comment

By Melissa Patrick
Kentucky Health News

By a very small margin, Kentuckians think insurance rates should be higher for smokers if the insurance company provides a free smoking cessation program, but most don't think rates should be higher for those who are overweight, says the latest Kentucky Health Issues Poll.

The poll, taken Oct. 8 to Nov. 6, found that 50 percent of Kentucky adults said it would be justified to set higher insurance rates for people who smoke, while 45 percent said it wouldn't be justified. Five percent were undecided. This finding was basically the same whether the person had insurance or not.

The poll's margin of error was plus or minus 2.5 percentage points, which applies to each number, so the results were right on the error margin. That means in 19 of 20 cases, the results would be the same if the entire adult population of Kentucky were asked the question.

The poll found that most Kentuckians who have never smoked (63 percent) said insurance companies should not set higher insurance rates for people who smoke. Former smokers, at 51 percent, were less likely to agree with that opinion.

With about 27 percent of Kentuckians smoking, Kentucky leads the nation in smoking percentage, lung cancer and lung cancer deaths, which collectively come with a price tag.

Smoking cost the state $1.92 billion a year for health-care expenditures directly as a result of tobacco use, which amounts to $988 million a year in total taxpayer cost from smoking-related expenses, or $591 per household, Wayne Meriweather, chief executive officer of Twin Lakes Regional Medical Center in Leitchfield, representing the Kentucky Hospital Association, told legislators in December.

The poll also found that the majority of Kentucky adults, 67 percent, think it is unjustified to set higher insurance rates for people who are significantly overweight. Opposition was higher, 77 percent, among those who reported being in fair or poor health; among those who said they were in excellent or very good health, only 58 percent were opposed.

Kentucky ranks fifth in the nation for adult obesity, with one in three Kentuckians considered obese, according the "States of Obesity" report. This also comes with a price tag.

A study in the American Journal of Health Promotion found that a morbidly obese employee costs his or her employer approximately $4,000 more in health care and related costs every year than an employee of normal weight.

The poll was sponsored by the Foundation for a Healthy Kentucky and Interact for Health, formerly the Health Foundation of Greater Cincinnati, and was conducted by the Institute for Policy Research at the University of Cincinnati. It surveyed a random sample of 1,597 adults via land lines and cell phones.

Princess Health andHigher-income Kentuckians' reported health keeps declining; reports from those with lower incomes go up, marginally.Princessiccia

Princess Health andHigher-income Kentuckians' reported health keeps declining; reports from those with lower incomes go up, marginally.Princessiccia

Affordable Care Act Foundation for a Healthy Kentucky health health reform income Patient Protection and Affordable Care Act poll polls

Gusty 20:29 Add Comment

A statewide poll again finds that Kentuckians with higher incomes consider themselves in better health than those with lower incomes.

The latest Kentucky Health Issues Poll, taken Oct. 8 through Nov. 6, found that 55 percent of Kentucky adults who are above 200 percent of the federal poverty level (FPL) said their health was either "excellent" or "very good," compared to 29 percent of Kentucky adults at or below 200 percent of the FPL. The FPL for a family of four in 2014 was $47,700.

However, the percentage of Kentucky adults in the higher-income category reporting excellent or very good health has dropped significantly since the poll started asking this question in 2008, to 55 percent in 2014 from 66 percent in 2008. So has the overall percentage of Kentucky adults reporting excellent or very good health, dropping to 41 percent in 2014 from 49 percent in 2008.

The percentage of lower-income Kentucky adults reporting excellent or very good has been about the same since 2008. This year the poll found a 3 percent increase among those in this group who reported very good or excellent health. The difference is not statistically significant, but coincides with implementation of federal health reform, and and if it continues could show the law's impact.

The poll also found that 52 percent of adults age 45 and younger considered their health as excellent or very good while 33 percent of those over age 45 reported excellent or very good health.

�KHIP provides important data regarding the connections among a person�s age, earnings level and perceived health status,� said Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll. �By asking the same question year to year, we can spot trends in perceived health. The latest results are an important reminder of the links between poverty and poor health.�

The poll is conducted by the Institute for Policy Research at the University of Cincinnati and is co-sponsored by Interact for Health, formerly the Health Foundation of Greater Cincinnati. It surveyed a random sample of 1,597 adults via land lines and cell phones, and has a margin of error of plus or minus 2.5 percentage points. That applies to each figure, making the 3 percent difference statistically insignifcant.

Princess Health and Princess Health andMcConnell presses Democratic foe Grimes to say how she feels about Obamacare, but won't bite on questions about Kynect.Princessiccia

Princess Health and Princess Health andMcConnell presses Democratic foe Grimes to say how she feels about Obamacare, but won't bite on questions about Kynect.Princessiccia

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Gusty 17:23 Add Comment

By Al Cross
Kentucky Health News

At his first press conference after winning the Republican nomination for a sixth term, U.S. Sen. Mitch McConnell pressed Democratic nominee Alison Lundergan Grimes to clarify her position on the federal health-care reform law but wouldn't say whether his plan to "start over" on the issue would include shutting down the state's successful health-insurance exchange.

"She's been dodging it for a year," McConnell said Friday. "She's been in this race for a year. It's time for her to answer the question, "How do you feel about it?" Grimes, Kentucky's secretary of state, twice refused Wednesday to say how she would have voted on the 2010 law if she had been a senator.

McConnell speaks at half-hour press conference.
(Associated Press photo by Timothy D. Easley)

The topic arose when McConnell was asked to reply to Democratic assertions that his pledge to "pull it out root and branch" would end the law's insurance coverage for 415,000 Kentuckians through the state exchange.

The senator didn't answer directly. "This is another good reason why the two of us ought to have a real debate," he said, recalling his post-primary proposal for three Lincoln-Douglas-style debates by the middle of September.

Asked if he would dismantle the state exchanges created under the law, McConnell said he would have created a national market -- "tear down the walls, the 50 separate silos in which health insurance is sold" -- passed medical-malpractice reform, and allowed small businesses to "band together in this international [sic] market."

Asked again, specifically, if he would shut down Kentucky's exchange, which is branded as Kynect, he said "I think that's unconnected to my comments about the overall question here."

While polls have shown the law to be unpopular in Kentucky, a small plurality of voters in a recent poll had a favorable opinion of Kynect. Last fall, the Kentucky Health Issues Poll found that people who weren't sure how the law would affect them and their families had an unfavorable opinion of it, while those who said they did know how it would affect them had a favorable opinion.

In his overall comments about the law, McConnell said a Congressional Budget Office study has predicted that full implementation of the law would still leave 30 million Americans uninsured, covering only 10 million. "What is the cost-benefit ratio of this kind of destruction, this kind of impact, on 16 percent of the economy?" he asked. "The people of this state are entitled to know the answer to the question, 'How do you feel about it?' and I think my opponent has tried to dodge that question."

UPDATE: Joe Sonka of LEO Weekly writes, "According to the CBO, by 2024 the number of uninsured will, in fact, be 31 million people, but without the ACA there would have been 56 million people uninsured. This number takes into account the undocumented immigrants who can�t get insurance because of the lack of immigration reform, and the people who can�t get Medicaid in states that opted out of the Medicaid expansion. That means that when the ACA 'kicks in fully' . . . 26 million will have gained access to health-care coverage because of it."

Asked if repealing the law would be his top priority as majority leader if Republicans take control of the Senate, he said he wasn't ready to say because he's not in the majority yet, "but I think it's reasonable to assume that would be a high priority for us." He noted that Obama will be president until January 2017, an implicit acknowledgement that Obama would veto any repeal and two-thirds votes of the House and Senate would be required to override him.

Jason Millman of The Washington Post writes that the issue could be pivotal in the race. "Kentucky is about as big of an Obamacare paradox that you could find: the state's exchange is working well, but Obamacare remains unpopular in the state," he writes. "It�s also home to one of the more successful Obamacare health insurance exchanges." He concludes, "Grimes may want to have a better answer the next time she's asked whether she would have voted for the health-care law." She has refused to say.