Expanding Medicaid is about more than money

It’s a matter of life and death

Not to Rick Perry it doesn’t

If Texas doesn’t expand Medicaid, it will reject more than $100 billion in federal money the first decade, according to the state’s own figures. To get that sizeable federal reimbursement, the state would have to spend about $16 billion over 10 years. The governor’s refusal to take the federal government’s billions puts him in an awkward position opposite some of the state’s most powerful economic players: hospital chains, local governments and chambers of commerce. Given that political pressure, Perry might strike a deal with the Obama administration, or the Texas Legislature could push for a Medicaid expansion.

Beyond the economics and politics, lives are at stake. Lack of insurance will certainly mean more deaths. How many more? Approximately 9,000 a year, according to Dr. Howard Brody, director of the Institute for Medical Humanities at the University of Texas Medical Branch in Galveston. Brody calculated that figure by extrapolating from a recent Harvard University study published in The New England Journal of Medicine that found that states that expanded Medicaid saw a 6.1 percent reduction in the death rate among adults below 65 who qualified for the program. In a recent op-ed in theGalveston Daily News Brody wrote, “This means that we can predict, with reasonable confidence, if we fail to expand Medicaid . . . 9,000 Texans will die each year for the next several years as a result.”

Too often the political debate around Medicaid expansion is about dollars and cents, Brody told me recently. “It’s presented as if it weren’t about life and death,” he said. Brody teaches ethics to medical students at UTMB, so for him, the issue of Medicaid expansion, when you cut through the rhetoric and endless policy discussions, is a deeply moral question: Should Texas allow people to die simply because they can’t afford health insurance? “Whose life and death are we talking about?” said Brody, who treated Medicaid patients for decades before becoming a professor at UTMB. “Politically, the Medicaid population are simply invisible folks. Most Americans may not care very much, because they think, ‘I’m not in that group of people and that’s somebody else and so it’s somebody else’s problem.’”

Perry has contributed to this attitude by arguing that uninsured Texans can receive health care in emergency rooms. “Everyone in the state of Texas has access to health care, everyone in America has access to health care,” Perry said at a New Hampshire campaign event in November 2011, according to the liberal website ThinkProgress. “From the standpoint of all people in this country, our government requires that everyone is covered.” Perry is correct that anyone can get treated in an emergency room—but it’s expensive. And not everyone in Texas has access to health care. People with chronic conditions—especially those with cancer—face a bleak future without health insurance. They are among the thousands of Texans whose lives could be saved by Medicaid expansion.

[…]

Medicaid expansion would help people like Mario Reyes, said [Kevin Moriarty, CEO and president of Methodist Healthcare Ministries], who is frustrated by Perry’s rejection of the program in Texas. “We’re talking 1.5 to 3 million people around the state who are going to get late care or no care,” he said. “They’re going to suffer, they’re going to be in pain because we can’t make a better policy decision.”

Sure is a good thing Rick Perry is pro-life, huh? Read the whole thing.

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• We really should have expanded Medicaid
• Once again, the cost of not expanding Medicaid