Michigan has great access to health care. Health outcomes are another story

Michigan has some of the best access to health care in the nation, but like much of the Midwest, ranks in the bottom third of the nation in overall personal health.

It’s a dichotomy that has persisted for decades, as a tradition of good-paying, union jobs has provided a better network, on average, of hospitals, insurance and access to primary care doctors than the rest of the nation.

Even so, Michigan ranked 32th in overall health in 2019, according to the United Health Foundation, a Minnesota-based nonprofit that works to improve public health. 

And the rankings predate the greatest health crisis in a century: the coronavirus pandemic, which has killed more than 220,000 people nationwide since March. Early in the pandemic, Michigan was one of the hardest-hit states, and ranked 10th in deaths on Oct. 19, which is roughly proportionate to its population.

As a state, Michigan has higher rates than the national averages for smoking (19 percent vs. 16 percent); drug deaths (23.9 per 100,000 vs. 19.2) and heart disease deaths (300 per 100,000 vs. 260). Life expectancy in Michigan was a full year less than the national average (75.2 for men, 80.2 for women), according to state statistics.

Still, Michigan ranks high among states nationwide in access to insurance in the nation (No. 7), the number of primary care physicians (No. 6) and immunization rates among adolescents (No. 5).

The discrepancy has persisted for years, but some critics say it’s been exacerbated by a disinvestment in public health. 

Michigan is in the Top 10 for the least amount of money spent per capita on public health, according to a 2017 report from the nonpartisan Citizens Research Council of Michigan. Since 2004, state-supported spending on health has dropped 16 percent when adjusted for inflation, the report found.

What lawmakers are doing

Michigan’s boosted access to insurance by extending Medicaid to more than 600,000 people through the Healthy Michigan program as part of the 2010 Affordable Care Act, or Obamacare. 

In January, Michigan joined nine other states to implement rules requiring adults who receive the benefit to work at least 80 hours a month or document why they can’t. The rules would apply to some 238,000 Michiganders.

Similar rules in other states have sparked lawsuits, accusations of thousands losing insurance and overall uncertainty. But Republican backers of the plan in Michigan say it’s a commonsense reform to ensure those receiving benefits get off public assistance.