“Access” to healthcare is in the eye of the beholder. Of Indiana’s 92 counties, 30 no longer offer access to obstetrics care, according to the Indiana Rural Health Association. It’s just too costly: hospitals that shut down their obstetrics services found that most of their patients either had no insurance or were recipients of Medicaid, which only pays about 30 cents for every dollar’s worth of medical care delivered.
“In 30 counties, you can’t birth a baby,” said association President Don Kelso, who illustrates the problem by talking about the 70-mile stretch in west central Indiana filled with O.B.-less counties. “Between Terre Haute and Avon, there’s no place to birth a baby.”
There are 35 critical-access hospitals located in medically under-served rural areas in Indiana; 11 of them are losing money and the rest are under considerable strain.
Pence is correct: There is a safety net for the ill and uninsured. But it’s a tattered one.
That’s what a 2012 report commissioned by the Indiana State Department of Health found. The report, authored by the Indiana Primary Care Association, looked at Indiana’s healthcare safety net and concluded this: “Even with these various safety net options, providing health care services to all who need it remains a challenge. Approximately 1.5 million low-income Hoosiers have inadequate access to health care services.”
“We do have access, but the health of Hoosiers is not good,” Kelso said, before listing a litany of ills that include Indiana’s high rate of diabetes, heart disease, obesity, and infant mortality (which is related to lack of access to pre- and post-natal care.)
The governor’s own health commissioner, Dr. William VanNess, recently noted that an infant born in Indiana has a higher rate of dying before its first birthday than almost anywhere else in the nation. Indiana now ranks 47th out of the 50 states in infant mortality.
Kelso sees that as a signal of failure by both the healthcare industry and the state: “We’re down near the bottom. We’re right down there with Mississippi and Arkansas in the number of babies that are dying. Think about that.”
Maureen Hayden covers the Statehouse for the CNHI newspapers in Indiana. She can be reached at firstname.lastname@example.org