ST. LOUIS -- A study released Wednesday by a nonprofit health foundation started with a question. How much is Missouri spending each year on health care?

The answer, the Missouri Foundation for Health study says, is more than the national per-person cost and yet, the state ranks near the bottom in just about every measure of health.

"We're not getting enough from our investment," said James Kimmey, president and CEO of Missouri Foundation for Health, which commissioned the study. "Despite the spending, we're not getting results one would expect."

The study says that Missouri's health-care costs are rising above the national average while the state ranks poorly on such health indicators as obesity and deaths due to heart disease.

The study says Missouri will spend about $30 billion on health care this year, nearly $8 billion more than previously estimated.

The study was conducted by Kenneth Thorpe, professor and chair of the department of health policy and management at Emory University's Rollins School of Public Health. Thorpe has done similar studies for other states.

Thorpe, who did not attend a news conference announcing the results, calculated health spending from such sources as Medicare, Medicaid, Missouri Department of Insurance, Workman's Compensation, Ryan White funds for AIDS services and the state budget.

Among the findings:

Missouri will spend $5,395 per person on health care in 2003 as compared to $4,951 nationally.

That represents an annual increase of 7 percent in Missouri since 1998 as opposed to 5.7 percent for the nation.

Missouri ranks in the bottom third or two-thirds of states on many major health indicators. Missouri is No. 9 in heart disease deaths, No. 12 in obesity.

Missouri spent more of its health-care funds on hospital services than the nation as a whole, 41.2 percent to 35.9 percent. But it spent less for physician and other professional services, 24.7 percent to 28.4 percent nationally.

Dr. Hugh Stallworth, director of the St. Louis Health Department, said the report tells him that public health efforts must be strengthened to prevent illnesses before they rise to the level of expensive hospitalization.

"Without access to prevention, we all pay a higher bill," said Susan Talve, a St. Louis rabbi and health activist. "The sicker some of us are, the sicker all of us are."

Positive news

There was some positive news. The study found Missouri has fewer uninsured individuals compared to the national average -- 12 percent for Missouri to 16.5 percent for the nation. That's because the state has a higher level of employer-sponsored insurance coverage -- 71 percent compared to 65 percent nationally.

However, more than 500,000 Missourians still live without any health-care insurance coverage. Most have incomes below the national poverty level.

Kimmey said a second study by Thorpe due out in a few weeks will calculate the cost to provide health-care coverage to all Missourians. The preliminary results show a universal health-care plan would cost less than what is currently being spent in Missouri.

Thorpe, reached by phone in Atlanta, said the savings would be the result of reduced administrative costs.

"We find that exciting because we'd be spending less and yet, a half-million more people would be covered," foundation spokeswoman Heather McClurg said.

Currently, nearly $30 billion is spent each year on health care in Missouri, from prescription drugs to nursing home care. Thorpe calculated the cost of three coverage models to range from $27 billion to $28 billion. The foundation is not endorsing any model.

The Missouri Health Foundation was established in January 2000 through the for-profit conversion of Blue Cross/Blue Shield of Missouri. It is the largest health-care foundation in the state, and the nation's third-largest.

The foundation makes grants -- 189 grants so far, totaling $41 million -- and educates policy makers and the public on health matters.

On the Net:

http://www.mffh.org