Washington State's health system in trouble, says report

“WASHINGTON’S HEALTH care system is in trouble,” according to a study released by the Health Policy Analysis Program (HPAP) of the University of Washington.

The 2002 Pulse Report revealed increases in major health trends such as health-care provider shortages, health insurance premiums and the percentages of people without health insurance since 1999.

HPAP has been tracking major indicators of Washington’s health system since 1997 as part of its Vital Signs of Washington’s Health Initiative. The 2002 Pulse Report tracks national, state and local data to address three primary questions about Washington’s health system:

• Are people in Washington getting the health services they need?

• Do people have health insurance and where do they get it?

• Who pays for health services and how much?

Shortages of Primary Care Physicians and Nurses

In 2001, 38 of Washington’s 39 counties had federal designation as primary care health professional shortage areas, up from 23 counties in 1998. HPAP’s research revealed severe shortages in parts of Ferry, Pend Oreille, Spokane, Columbia, Benton, Franklin, Grant, Yakima, Clark, Pierce, King and Skagit counties.

Nurses are also in short supply, according to the study. The number of RNs per 100,000 people declined from 775 in 1996 to 738 in 2000. The national rate in 2000 was 782 per 100,000.

Fifty-four percent of RNs in Washington were employed full-time in 2000, compared to 72 percent for the nation. In 2001, 66 percent of Washington’s urban hospitals and 46 percent of rural hospitals had to divert patients to other hospitals due to a shortage of nurses (not just RNs).

Increase in the Uninsured

The percentage of uninsured increased from 8.4 percent in 2000 to 10.7 percent in 2002, according to data from the Washington State Population Survey. Some rural areas registered higher percentages, including 16 percent in Eastern Washington.

“The number of people without health insurance is likely to increase if cuts are made in the Basic Health and Medicaid programs to help balance the state budget,” Patricia Lichiello, senior policy analysts and executive editor of the report, said.

Increases in Health Insurance Premiums

Per capita spending on health care in Washington remained below the national average and is increasing at a slower pace—two positive trends. However, health insurance premiums jumped dramatically for private sector employees and government payers. Average premiums in Washington for private sector employees increased 19.4 percent in 2000. Premiums for public sector health insurance are expected to increase 20 percent in this year.

In the individual insurance market, premiums rose by double digits each year from 1997 to 2001, rising almost 24 percent in 2001.

University of Washington release, February 12

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