Tuesday, April 9, 2013

The Unfinished Business of Medicaid Reform

Editor's Note: The following op-ed was penned by Democratic state senator Dan Schmidt and deserves a read. Since the session ended, I haven't stopped thinking about the message in his op-ed and what a huge opportunity the GOP-driven legislature passed up. The money saved by the state by expanding Medicaid as well as the many benefits to the people of the state who desperately need an expanded Medicaid program apparently does not outweigh the political points scored by conservative legislators who can continue to rail against the socialism and federal government overreach of such an expansion. The entire situation is terribly sad for a state that could benefit greatly.

Unfinished Business
by Senator Dan Schmidt

The Idaho legislature adjourns with unfinished business. As health care reform moves forward, Idaho will have 100,000 people, many working poor without health coverage unless they have a catastrophic illness or injury. Then county taxpayers will pick up the bill, after the injured is found indigent, liens are filed and bankruptcy ensured.
Last year, that cost counties about $40 million in property taxes. And if the cost per case is more than $11,000, the state pays the remainder. Last year, that cost Idaho taxpayers $35 million in general fund dollars. Almost all these people could have insurance coverage if Idaho chose to revise and expand Medicaid coverage as allowed and funded through the Affordable Care Act, yes, Obamacare. And that right there might explain the political reluctance. The numbers are clear, but this should be about more than just numbers. This needs to be the right choice.
We currently pay for health care for this population in an inefficient way. After the care has been provided, the injured or ill are determined to be impoverished then the hospital and physician are reimbursed with taxpayer dollars. Does this make sense to you? I understand the fear of expanding an entitlement program. As a family doctor, I always encourage appropriate use of services. If my patients, my neighbors or my family act irresponsibly, they hear from me. Health is something for which we can all take some personal responsibility. But that doesn’t mean we need to be stuck with how we have always done it. The Governor’s Work Group concluded that more of the same old Medicaid program wouldn’t suit this population or Idaho. So a unique benefits package was proposed that enrolls this group with monthly premiums and co-pays and a health savings plan.
Understand that by having these otherwise uninsured people paying co-pays and monthly premiums, even at very low rates, we will encourage people to avoid seeking their primary care in the emergency room and instead put the pressure of wise consumption and market forces onto our rising health care costs. This benefit plan can inspire responsible consumption. They can contribute, as we all can to the solution.
Health care costs are crippling our economy and clouding our future. We cannot control costs after the care has been given. Enrolling all Idahoans, managing the costs, holding patients and providers responsible can start Idaho down a different path. If we as a state don’t have the courage to take on this problem, then we aren’t behaving responsibly. We have work to do. 

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