This post originally appeared at https://www.badgerinstitute.org/wisconsinites-health-is-deteriorating-madison-needs-to-wake-up/

We just received another wakeup call on health care in Wisconsin, where costs are too high, public health outcomes have plummeted, and our governor has hit the snooze button.

In the latest edition of America’s Health Rankings, published Jan. 28, Wisconsin ranked 33^rd in health outcomes. The Badger State fell from 12^th best in health outcomes in 1990 to 19th in 2019 before a change in methodology, to 33^rd today.

Wisconsin’s ranking for children’s health outcomes is even worse, dropping to a record low of 39^th in 2024. Similarly, the Centers for Disease Control in late 2024 noted that Wisconsin had fallen to 49^th in immunizing school kids. That was followed by the news that Wisconsin had the nation’s third largest number of whooping cough cases and the state’s first childhood influenza-related death of the season.

In opioid deaths, a tragedy increasingly striking teens, the Wisconsin death rate is twice the rate of Iowa and 25% higher than Minnesota’s.

Health costs, meanwhile, have soared to more than $25,000 a year per family of four.

Health costs have risen until they are the top issue for Wisconsin businesses in the latest Wisconsin Manufacturers and Commerce survey. The latest independent RAND Corporation report shows Wisconsin with the highest hospital costs in the Midwest — and sixth highest in the country. The WMC’s report was titled “An Arm and a Leg,” an apt folksy description of what Wisconsin health care costs.

Driving some of those costs is the epidemic of hospital and health system mergers. The latest merger was completed Jan. 1, with Marshfield Clinic, once the largest clinic in Wisconsin, merging with Sanford Health of South Dakota. The headquarters is moving to Sioux Falls, S.D. It was the sixth megamerger in Wisconsin in the last three years.

In every neighboring state, the attorney general has held hearings on the mergers. In some states, there were conditions put on the merger. Wisconsin had no hearings by Attorney General Josh Kaul — and no conditions.

The Biden administration on Jan. 15 issued a long-delayed report on hospital consolidation and prices. It stated, “Empirical research unambiguously shows that hospital system-led acquisitions and mergers are associated with higher prices.”

It goes on, “Research also shows that consolidation reduces wage growth for health care workers.” And it concludes, “The rising cost of health care is one of the economy’s most significant drivers of inequality. It operates like a head-tax on every working family, putting enormous strain on vulnerable communities and the broader economy.”

The generally Republican-aligned state chamber and the Biden administration were aligned in saying the same thing: “Wake up.”

Ironically, Wisconsin’s overall tax rankings have improved from the bottom ten to middle of the pack. But the hidden “head-tax” of health costs has gone in the opposite direction.

These continuous wakeup calls on health care have gone unanswered.

A January report from the Robert Wood Johnson Foundation and the Urban Institute addressed two fundamental measures of health outcomes: life expectancy and the racial disparity in life expectancy. The report noted that only two areas in the country had increasing racial disparities in life expectancy — the District of Columbia and Wisconsin. Health statistics are complex and frequently cherry-picked to serve a writer’s bias. But life expectancy is a real number.

Wisconsin does have excellent physicians and generally high-quality hospitals. Every study shows that. In the America’s Health Ranking report that showed declining public health outcomes, Wisconsin was ranked 11^th best in the country in clinical outcomes for doctors and hospitals. In Wisconsin, though, that has not translated into lower costs and better public health outcomes.

The growing Wisconsin health care crisis is not caused by doctors and nurses. It is caused by the “suits” running giant health systems and by state government health policy and administration.

Many states face challenges. A December 2024 Gallup report showed record dissatisfaction with the health system nationally because of rising costs, denials by insurance companies, and a failure of the public health profession’s handling of COVID.

But some states do better than others. Wisconsin was once widely recognized as a top state for health care. President Bill Clinton appointed University of Wisconsin-Madison Chancellor Donna Shalala as U.S. secretary of human services. President George W. Bush later appointed Wisconsin’s Governor Thompson as her successor. Those appointments reflected Wisconsin’s health care success.

Much has changed. UW-Madison today runs the most profitable hospital in Wisconsin and controls the largest health insurance company in the state. Yet in contrast to the successes of Shalala and Thompson, today Wisconsin faces a growing health care crisis — a wakeup call for leadership in Madison and in the University of Wisconsin system.

The depressing new statistics raise the question: Will anyone in Madison wake up?

It can start with setting a clear goal for Wisconsin to once again be a top state on health outcomes. Step two would be to create a regular state health care report card. Step three would be for the governor to call the state health system leaders and the UW System president to a meeting to demand a strategic statewide health care action plan. One good result from rampant system mergers is that it will be a small meeting.

Finally, the Trump administration will be giving states greater flexibility with federal Medicaid dollars. Those dollars need to be linked to lower costs and better measured public health outcomes.

John Torinus is the retired CEO of Serigraph and author of two books on health care. Tom Hefty is the retired chairman and CEO of Wisconsin Blue Cross, which created the now $1 billion public health endowments at the University of Wisconsin-Madison and the Medical College of Wisconsin.

The Badger Institute welcomes guest analyses that prompt discussion, including counterarguments, of issues important to the state and its residents.

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