Nearly 300,000 more Missourians could soon get access to health care if Missouri state officials decide to provide it. Unfortunately, recent comments by the state Legislature’s leadership cause us to believe that they seem poised to deprive Missourians of this basic human right.
We, members of the Consumers Council of Missouri, urge the public to consider this decision carefully and act in the best interest of our friends, families and neighbors. Missourians must insist that members of the House and Senate and Gov. Jay Nixon not tolerate avoidable human suffering. As stewards of health care for hundreds of thousand of poor Missourians, these state officials should increase the role of Medicaid in the manner spelled out by the Affordable Care Act.
It’s humane and compassionate, and it makes economic sense for Missouri consumers.
The Missouri Foundation for Health recently determined that over the next five years, the ACA would pump $8 billion into Missouri to expand health care to the 300,000 people. The state would be responsible for only $400 million, a small amount in comparison. If policymakers are inclined to think that 5 percent responsibility is too steep for Missouri, they should appreciate that the $8 billion will primarily become taxable income for health care providers (that’s jobs, jobs, jobs). No matter how you do the math, it’s going to cost the state very little to save a bunch of lives and provide health care for hundreds of thousands of Missourians.
Compound that with the fact that each of us in Missouri already pays for the health care of these 300,000 uninsured members of our community. Who else pays when someone without insurance goes to a hospital with a heart attack or stroke? Long ago, we as a society decided that a hospital couldn’t turn away someone who is desperately ill. If the patient doesn’t pay, guess who does? Each of us. The hospital writes it off, but it does so by charging those of us who have insurance a bit more.
We need to take full advantage of the value the ACA brings to Missouri consumers, even though it is not the legislation we believe would benefit Americans the most. The biggest problem with the ACA is that it preserves the dominant role of the private insurance industry in health care. With private insurance involved, for every dollar spent in the health care system, 31 cents pays for administration, profits and overhead. Instead of paying for actual health care, our premium dollars pay for those employees whose job it is to tell policyholders that we can’t get the health care we need, or to call doctors to explain that a prescription the doctor wrote isn’t the insurance company’s “preferred” prescription.
The Consumers Council of Missouri believes that consumers would best be served by fixing Medicare and providing it to all Americans. The ACA failed to do that. But it was enacted with the promise that it would create affordable insurance coverage for roughly half of today’s uninsured Americans. And much of that happens by expanding Medicaid and requiring the states to pick up less than five percent of the tab.
By taking advantage of the ACA and providing health care to at least a portion of uninsured Missourians through the Medicaid expansion, the state would let the federal government purchase, for example, a bottle of pills to treat high blood pressure. Our state’s leaders appear to prefer to let patients suffer, get overwhelmed by a massive illness, declare bankruptcy and wind up costing each of us plenty more than it would cost to expand Medicaid under the ACA.
Where is the fiscal prudence in this strategy? Where is the justice for the consumers who are rationed out of health care? Where are the moral ethics that should guide our state’s political discussions? Where are the hearts and minds of anyone who could oppose providing the basic human right to health care?
We urge the members of the Legislature and the governor to choose access for more health care consumers in Missouri and financial prudence for the state coffers by expanding Medicaid under the ACA. Tomorrow, improved Medicare for all. Today, let’s at least take full advantage of the law and save some lives.
Dr. Ed Weisbart is a board member of the Consumers Council of Missouri and chairman of Physicians for a National Health Program-St. Louis. This commentary was previously printed in the St. Louis Post Dispatch.