Vermont leads the nation in the delivery of its health care, while Mississippi is rated the worst, according to a non-partisan study that compares all 50 states and the District of Columbia.

Vermont, Hawaii, Iowa, Minnesota, Maine and New Hampshire ranked 1 to 5 in 38 indicators of health care.

At the bottom were Mississippi, along with Oklahoma, Louisiana, Arkansas, Nevada and Texas.

The Commonwealth Fund Commission’s “Scorecard on Health System Performance,” rated the states on access, quality, costs and health outcomes in a follow up to their 2007 report.

Overall, the states which did best on the Commonwealth scorecard were in New England and the upper Midwest, and the worst states were in the South.

Vermont, with only 640,000 residents, has nearly universal health care coverage with 93 percent insured. Its innovative “Blue Print for Health” focuses on prevention of chronic diseases.

“We’re small. There are 19 cities larger than the state of Vermont,” said Susan Besio, director for health care reform and Medicaid for Vermont.

“But I believe there is something unique about Vermont in terms of its culture,” she told ABCNews.com. “We want to take care of each other and we are a healthy state.”

In Mississippi, however, about 20 percent are uninsured despite having some of the highest rates of hypertension, diabetes and asthma.

According to the report, only 35.7 percent of adults 50 or over in Mississippi receive recommended screening and preventive care.

“When you compare Mississippi on almost any socio-economic profile, we are a struggling population that has a large percentage of low-income individuals, high unemployment rates, low rate of education,” said Robert Pugh, director of the Mississippi Primary Health Care Association.

The scorecard “paints a picture of health care systems under stress, with deteriorating health insurance coverage for adults and rising health care costs,” according to co-author Cathy Schoen, who is senior vice president of the commission.

“Where you live matters for access, quality of care and whether you live a long and healthy life. These wide and persistent gaps among states highlight the need for national reforms and federal action to support states.”

For example, 32 percent of working-age adults in Texas are uninsured, compared to only 7 percent in Massachusetts in the most recent survey.

“It’s very hard to have a high performing health care system and hospitals that do well for everyone if you have a high rate of uninsured in the state,” said Schoen.

In 1999-00, there were only two states with 23 percent or more of adults uninsured. But by 2007-2008 there were nine.

Children fared much better, due in large part to the Children’s Health Insurance Program (CHIP) under Medicaid. The number of states with 16 percent or more of children uninsured dropped from nine to three during the same time period.

Other findings of the report were that in a, costs rose and quality improved in areas where outcomes were reported to the public.

Vermont’s ‘Blue Print For Health’ A Model

The Green Mountain state was cited for its model “Blue Print” program. Launched by Republican Gov. Jim Douglas, it covers everything from teaching children healthy eating to helping seniors stay in their homes rather than going to costly nursing homes.

“You betcha, I feel good about the reforms we put in place,” Douglas told ABCNews.com. “It’s centered on quality and containing costs. Care shouldn’t start in the emergency room.”

All Vermonters are encouraged to have yearly exams and adults are notified when they are due for check-ups.

Douglas talks to children about “getting off the couch” and set an example just this week by joining elementary students on a walk to school.

With the second oldest population in the nation, Vermont subsizes care for seniors and the disabled to defray the costs of home care. Nursing home beds were reduced by 200 last year.

In one pilot program, electronic medical records can avert expensive tests like MRIs and x-rays. One emergency room doctor seeing a woman with stomach pains discovered in her online medication history that she had not filled her prescription for ulcer medicine.

“It takes time and so a lot of the fruits come from years of work and planning and cooperation,” said Douglas.

Health Care Affects a State’s Economy

But Mississippi, with the highest infant mortality and low birth rates in the nation, makes access to these Medicaid programs more difficult, according to Roy Mitchell, director of the Mississippi Health Advocacy Program (MHAP).

“I am not at all surprised we were 51st on the list,” he told ABCNews.com. “We are last on several health indicators. Our policy makers work hard at being last.”

Despite one of the highest matches of federal to state dollars in Medicaid funding, the state mandates “face-to-face” eligibility, requiring all new applicants and those reapplying for benefits to come in for an interview.

“As a direct result, 65,000 children have fallen off the rolls,” Mitchell said.

“Mississippi does virtually no outreach at all. They don’t publish where these face to face stations are and what times,” he said. “It’s a bureaucratic maze even to find out where to go. And when they get there they don’t have a certain document.”

Of those, about 77 percent would be eligible, he said. “It’s touted as fraud prevention.”

These disparities between the highest and lowest ranked states could be alleviated with national reform, according to Commonwealth.

The report emphasizes the need for insurance reform that rewards good outcomes, payment reform with an emphasis on prevention and advanced information systems that travel with the patient from physician to physician, saving time, money and preventing errors.

“What the scorecard is showing is that we have a system under stress, no matter where we live,” said co-author Schoen. “The costs are rising more than people’s incomes. We need to act.”

Schoen said she has hope for reform. “There is real leadership and people are taking reform seriously.”

Source: ABC News

Log on to Healthbase to learn about medical tourism or to get a FREE quote for any surgery in the United States or abroad.

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MEDICAL TOURISM GUIDE

Today, cheap yet world-class surgeries are just a flight away. But the deluge of information available out there can overwhelm anybody. So, here is a quick guide to medical tourism to answer most of your questions about the phenomenon.

WHAT IS MEDICAL TOURISM?
Medical tourism is the process of traveling abroad to receive superior medical, dental and cosmetic care by highly skilled surgeons at some of the most modern and state-of-the-art medical facilities in the world…all at a fraction of the price in the US, UK and Canada.

MEDICAL TOURISM OFFERINGS
1. Incredible Savings: Compare a $7,000 hip resurfacing in India with a $48,000 one in the US. In general you are able to save 50% to 90%.
2. Excellent Quality: Many international providers are accredited by JCI, JCAHO and ISO or by local accrediting organizations. They have world-class facilities, have access to the latest technology and provide personalized service. If in doubt, read testimonials by patients who have experienced treatment overseas.
3. Surgeon Expertise: Most surgeons catering to international patients have either been educated or have received professional training at top schools in the US, UK or in other countries in Europe.
4. No Wait-Lists: Access to immediate service is what attracts those from countries that have public health care system towards medical tourism.
5. Longer Hospital Stay: You can have a longer hospital stay than possible in your local hospital back home under the supervision of your surgeon and physical therapist.
6. Travel Opportunities: While the primary motivation for most customers is affordable surgery, the opportunity to visit exotic destinations is an additional draw for some.

WHO SHOULD BE INTERESTED IN MEDICAL TOURISM?
In general, most medical tourists are either uninsured, underinsured or those seeking elective surgeries. Others resort to medical tourism due to the long wait-lists or unavailability of certain procedures in their country.

WHICH COUNTRIES OFFER THE BEST SERVICES?
The most popular medical travel destinations are India, Singapore, Thailand, Malaysia, Turkey, Mexico, Panama, Costa Rica, Brazil, Belgium, and Argentina amongst others. Some of these countries are considered best for cardiac surgery, others for orthopedic surgery and yet others for plastic surgery. You should base your selection on: quality, distance and cost.

CHOOSING THE RIGHT PROVIDER
When choosing a provider, don’t get swayed by attractive packages and fancy websites. Read and watch what others are saying about the particular hospital, clinic or surgeon. Check out the facility pictures and videos. Consider the provider’s accreditation, awards and recognitions, facility and equipments, statistics like success rates, etc.

WILL MY HEALTH INSURANCE PAY FOR IT?
Insurance companies are keenly looking into medical tourism as an option though most haven’t adopted it into their plans yet. So check with your health insurer for details.

SHOULD I COMBINE “SUN, SAND, AND SEA” WITH SURGERY?
That depends.
Usually after a cosmetic surgery, you are advised not to expose your body to the sun or to sea water. But, you can always choose to enjoy them before your surgery.
With certain other medical procedures, it’s best for you to stay indoors and relax after your surgery.
In any case, you should always consult your surgeon if you have travel or tourism on your mind.

WHAT ARE MEDICAL TOURISM FACILITATORS?
Medical tourism facilitators like Healthbase are specialized facilitators that connect you with the hospital of your choice while providing all or some other valuable services like detailed information about various procedures, detailed hospital profiles and surgeon profiles, medical records transfer, free surgery quote, pre- and post-consultation with the overseas hospital, feedback and testimonials from previous patients, medical and dental loan financing, passport and visa, airport pick-up and drop-off, hospital escort, tickets, travel insurance, hotel booking, tourism services in the destination country, etc.

This medical tourism guide is just a starting step. You should do the proper required research before you fly to your medical tourism destination.

You can learn more about the growing trend of medical tourism, international healthcare facilities and surgeons and the details of the medical tourism process by logging on to http://www.healthbase.com. Healthbase.com is a medical tourism facilitator committed to providing low-cost high quality medical travel services to the global medical consumer.

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