More physicians and dentists are practicing in Oklahoma than ever
before. But are the state's residents any healthier than they were
before the doctors arrived on the scene?
By several measurements, the answer appears to be yes, despite
clear knowledge that health care still lies beyond the reach of
thousands. Improving the so-called safety net to catch the
unemployed and low income people whose resources exceed the
eligibility requirements for Medicaid assistance is seen by some
observers as a critical step toward a healthier environment.
Whether action is near on this controversial front hinges
largely on the outcome of a major study here by the state's Council
of Health Care Delivery as well as congressional debate on
legislation intended to shore up the system. Although some members
of Congress favor a move to mandate health care insurance coverage
by the largest employers, and offer government-backed coverage to
the unemployed, the safety net gap is likely to remain untouched
until a new administration moves into the White House.
Certain recommendations are expected from the state council in
the fall, and the Legislature may be asked to intervene long before
the federal government gets around to dealing with the issue. It
is, however, a national issue.
More than 37 million people are believed to be without health
care coverage. In Oklahoma, the evidence indicates that at least a
quarter of the state's population is without coverage.
Hospitals here and elsewhere accept a certain level of
non-paying, or charity, patients, a practice that partially eases
the burden for the uninsured.
Records show, however, that fewer and fewer people re going to
Oklahoma's hospitals for treatment. Over the last several years,
the number of patient days has dropped by 23 percent, and the number
of occupied beds has fallen even more dramatically - from 61 percent
in 1982 to 46 percent in 1986, according to state officials. The
state has 130 acute care hospitals.
Through much of the same period, the supply of physicians
rapidly outpaced population growth. Between 1975 and 1980, the
state's population rose by 11.4 percent. At the same time, the
number of doctors - MDs as well as osteopathic physicians -
increased 27.3 percent.
While there are obvious benefits, health care experts say, the
growth in the supply of doctors does affect spending levels. But
those who measure health manpower levels now expect the rapid rise
to stop and possibly decelerate in the next decade, a trend that
would ensure lower inflationary pressures.
The supply of dentists, which are also part of the health care
equation, has risen from 42.8 per 100,000 of population to 46.6
dentists per 100,000.
The principal problem, however, is maldistribution among both
dentists and physicians - large numbers concentrated in urban areas,
too few in rural counties. Moreover, the state suffers from a
shortage of nursing personnel. Enrollments in baccalaureate nursing
degree programs have declined in recent years.
Structural changes notwithstanding, there are signs that
important public health gains are being made in Oklahoma.
Fewer births are being recorded, but the rate of infant
mortality, watched carefully by health authorities around the world
as a reliable barometer of society's general health, has begun to
show improvement here. …