A  medical chart concerning the status of health care in Ohio — stuffed full of test results, demographics and ohio health insurance insurance information — was opened and examined at a regional forum Friday afternoon in Cleveland.

In many ways the data — comprising Health Policy Institute of Ohio's 2008 Ohio Family Health Survey and various second-party findings — shows the state's health-care infrastructure has deteriorated over the last four years.

The data also suggests a discouraging prognosis if Ohio health insurance stays on the current course of treatment.

For starters, the percentage of uninsured working-age adults (18 to 64 years old) in Ohio rose from 15 percent in 2004, the last time the Ohio Family Health Survey was conducted, to 17 percent in 2008.

In Lake County, 14.2 percent of adults were uninsured in 2008; in Geauga, 10.7 percent; and in Cuyahoga, 17.6 percent. The average uninsured rate for Ohio's 17 suburban counties, which includes Lake and Geauga, was 12.3 percent — down from 14.1 percent in 2004.

There is a bright spot: The uninsured rate for Ohio's children (17 years old and younger) has dropped from 5.4 percent to 4 percent during that same four-year period.

"That tells us our government safety-net programs are working — at least for children," said Paul Quinn, director of communication for Health Policy Institute of Ohio, which hosted the forum.

Broken down by county, 3.1 percent of children in Lake County, 1.8 percent in Geauga County and 3.4 percent in Cuyahoga County were uninsured.

The study, which surveyed 50,000 households across Ohio between August 2008 and January 2009, also found that 35 percent of working-age Ohioans weren't working prior to being surveyed.

"Demographers have suggested that a healthy economy should have about 20 to 24 percent of its work force not employed," said William Hayes, president of Health Policy Institute of Ohio, explaining things such as early retirement can lead that figure to be higher than the widely reported unemployment rates. "In 2004, Ohio was at 31 percent, and now we're at 35 percent."

Largely responsible for that is the estimated 314,000 jobs lost across the state from the first quarter of 2001 to the first quarter of 2008 — figures that don't include the recent economic recession. Those job losses then equate to about $9.2 billion in annual lost wages, according to the Ohio Department of Job and Family Services.

Add those factors together, and you have diminished state and local tax bases to fund health-care programs and decreased purchasing power among families to afford their health-care needs, Hayes said.

Another disturbing finding from the survey was that being uninsured was not a short-term experience.

Nearly 64 percent of working-age adults reported they'd been without insurance for more than one year, and of those, 41.5 percent said they'd been uninsured for more than three years. For children, those figures were 47.3 percent and 28.1 percent, respectively, and all of those percentages are up from 2004.

While health-care programs require funding, higher spending doesn't guarantee higher quality health care. Citing data provided by the Dartmouth Institute for Health Policy and Clinical Practice, Hayes showed Ohio at the high end of the spectrum for spending but at the low end for quality.

Without reform, Ohio's health-care expenditures are projected to be $200 billion by 2018, said Hayes, citing Ohio Business Roundtable data. With reforms outlined in the report, the state could save from $41 million to $55 million by that time — a savings that amounts to about the same amount as the state's biennial budget.

"The cost of health care is bankrupting the country," said Frank Kellogg of the Lake County General Health District, adding that "prevention has to take a bigger role."

Terry Allan, health commissioner for the Cuyahoga County Board of Health, agreed.

"We have to invest in prevention," he said. "It's important to talk about a healthy work force. If you own a company and are thinking about moving (to Northeast Ohio), and if 40 percent of the kids are obese, what's that say about your (company's) prospective health-care cost?"

In addition to focusing more on prevention rather than reacting to and treating illnesses, HPIO officials recommend incorporating new and current health information technology, like electronic medical records, to reduce costs; reform medical payment methods to discourage the use of health-care services that are overused, underused or misused; and inform and activate patients to take a more proactive role in their health.

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