Personal health is a key issue for Alabamians and their governments. Health risks are generally high in Alabama, and more than a fourth of all spending by state and local governments goes toward hospitals and health care. This is second only to spending for education.
According to national reports, Alabama has the third-highest state death rate (after Mississippi and Louisiana), when adjustments are made for age differences in populations. Death rates from cancer and heart disease and among infants are all very high. High percentages of Alabamians smoke and are obese, two of the leading risk factors. Rural areas have few doctors.
The state has a number of assets in the fight to improve these rankings.
A high percentage of Alabamians is covered by health insurance, due partly to government-sponsored programs focused on women, children and the elderly. These include Medicaid, ALL Kids and Medicare. Medicaid and ALL Kids are partnerships between state and federal governments. Medicare is a federal program linked to Social Security.
These insurance programs are funded by taxes, federal grants and premiums paid by enrollees; in turn, they pay doctors, hospitals and other practitioners to provide services. Together they cover 97 percent of Alabamians 65 and older, 41 percent of Alabamians under 18 and 46 percent of babies delivered in the state.
Alabama’s Medicaid program is very restrictive on eligibility and services covered, according to a recent evaluation. However, Alabama ranked seventh among all states on quality of care provided. A large, new federal grant will enhance the information available to improve quality. Administrative expenses are only 2 percent of the Medicaid budget; 98 percent goes to pay benefits.
Alabama has a large number of hospital beds, more than a third publicly owned. This includes community hospitals in many counties and large, specialized medical centers at the University of Alabama at Birmingham (UAB) and the University of South Alabama (USA) in Mobile. UAB Hospital is rated among the top 3 percent nationally by U.S. News & World Report, with seven ranked specialties. The USA hospital is a referral center covering the Gulf Coast region of three states.
EDITOR’S NOTE — Jim Williams is the executive director of the nonprofit, nonpartisan Public Affairs Research Council of Alabama.
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