Expand Medicaid

By David Ball, R.N., M.H.A.
Charleston Post-Courier, June 12, 2013

In response to the June 5 story regarding the Affordable Care Act:

As a registered nurse for more than 20, years I look on in dismay as our health care system becomes more fragmented, inaccessible, and expensive. While the reasons are understandable, our problems have short-term fixes and long-term solutions.

Instead of embracing the achievements of the Affordable Care Act and improving it, our state leadership seeks the good old days of the 1830s when government had no involvement in health care financing and South Carolina ignored federal laws it did not like.

All industrialized nations, except ours, provide health care for their citizens. Our market based fee-for-service, coupled with private, for-profit health insurance, means that we pay twice as much as any other country, have 50 million uninsured and rank 39th internationally on quality of care.

The Congressional Budget Office (CBO) concluded that if we dropped the age of Medicare eligibility from 65 to zero (Medicare for all) we could replace private insurance (30 percent overhead) with public insurance (3 percent overhead) and provide every citizen with all medically necessary care (including medication) with no co-pays or increase in taxes. A bill in Congress (HR 676) would do just that.

Until universal health care becomes politically feasible we need to make do. When one of the 300,000 uninsured South Carolinians receives emergency care, the bill is passed to everyone else. The care may be free to them but it is not free to us.

By expanding Medicaid, hospitals get reimbursed for the care they provide without billing the rest of us.

Taking issue with the Affordable Care Act is fine. As an advocate for eliminating profit from health care financing, I, too, have a bone to pick.

Appealing to the U.S. Supreme Court on constitutional grounds is legitimate as well. But when the law is judged constitutional, it is illegal to ignore it and flat out wrong to impede it. Having 300,000 South Carolinians suffer to score political points is cruel and unjust.

When we choose which laws to obey, or ignore the rulings of the Supreme Court, we discard our moral authority and trash what it means to live in the United States.