“Yes” – By Kevin Puskar
Gov. Roy Cooper took office in January 2017 and immediately began working on Medicaid expansion. While state GOP lawmakers blocked his efforts to expand the federal health-care program for low-income residents, he continues to push for it despite the legislative roadblocks.
A proposed waiver amendment to Medicaid expansion notes that if “Carolina Cares” is approved by the General Assembly, the state would expand Medicaid. That comes with a work requirement that would apply to non-medically frail adults who aren’t taking care of a minor child, disabled children or parents, or people enrolled in a substance abuse treatment program.
In July 2018, healthins.org reported 2,037,412 North Carolina residents were covered by either Medicaid or the Children’s Health Insurance Program. Another 626,000 people would be covered if the state expanded Medicaid.
The report says 208,000 residents have no realistic access to health insurance without Medicaid expansion. The dollar amount the state is leaving on the table over the next decade by not expanding Medicaid through “Carolina Cares” is $36.1 billion.
In 2015, Cherokee County commissioned a Community Health Assessment that gathered data from several agencies, including Murphy Medical Center, across western North Carolina. The study concluded that more than 73 percent of local survey respondents were covered by Medicaid, Medicare, private insurance or another type of insurance. More than 26 percent had no coverage at all.
The age group most likely to have health-care coverage are 6-17 for both men and women. My wife reminds me that the burden of high insurance premiums is shared by employers and employees. The unemployed and part-time employees’ struggle is even worse.
Heart disease and cancer are the two leading causes of death in Cherokee County as well as North Carolina. The Community Health Assessment discovered the reason most local residents are not receiving medical care was lack of insurance. Key elements to good overall health include income level, employment, education level, community safety, housing, family and social support.
Hospital emergency rooms, the most expensive option, are being used today as primary care facilities. Most of us are only one major illness away from filing for bankruptcy. Everybody knows somebody with a health-care story.
Perhaps to some it’s more cost effective to just let people die; quietly, if you please. Politics aside, we are smart enough to find a solution. A moral society would. Expanding Medicaid will help.
Kevin Puskar of Murphy is a native of Florida. He earned a degree in computer engineering and technology before spending most of his working life in the computer and technology industry, then 12 years as a licensed financial advisor. He is also the author of A Path Runs Through It.
Undecided – By Hugh Williamson
For the 35 years that I was employed full time in the American workforce, the federal government deducted a certain percentage of money from each of my monthly paychecks to help pay for my medical expenses after I reached age 65. The percentage that was taken from my paychecks was supposedly matched by the federal government and set aside to be exclusively mine. This was Medicare.
I didn’t know where the government money came from. In one way or another, it came primarily from general income taxes because that’s the federal government’s primary source of revenue.
I never understood much about Medicaid because it never entered my life in a personal way. I vaguely understood that it was a program that provided medical assistance to low- or non-income earning people that was wholly paid for by the federal and state governments.
All of us would like to see good medical care for legal American citizens. I certainly would. But now that most states either have already expanded Medicaid or are considering doing so, we have to ask two hard questions.
First, where will the money to pay for the additional coverage come from? We are told the federal government will pay almost all the additional costs, but this simply means higher taxes on all working people in one way or another. Most working North Carolinians feel they already are taxed quite enough. Will they be willing to pay more to provide medical care for more non-working or low-income people?
Will some of the money come from my supposed personal Medicare account? Will some of it come from my retirement medical benefits guaranteed by my former employers, taken away from me by a government edict to pay other people’s medical bills?
Second, how will the additional care be provided? It’s already at times difficult to get appointments with many doctors, dentists and other medical professionals. It’s sometimes difficult to be scheduled for testing procedures on various machines and for some operations.
It does no good to create more “customers” for medical services unless more skilled personnel and equipment are available to meet the greater workloads that expanding Medicaid will create. When I know the answers to these questions of cost and care availability, I will know if I believe we should expand Medicaid or not. What I do know is there are no free lunches in life.
Hugh Williamson of Bellview is a native of Missouri. He holds masters and doctorate degrees from the University of Missouri. He spent most of his professional life as a teacher and administrator at the University of Idaho and University of Wisconsin-Stout.