LETTER TO THE EDITOR: Medicaid expansion benefits all Missouri residents

Thursday, April 4, 2013 | 6:00 a.m. CDT

Missouri Medicaid expansion is a major topic of debate for lawmakers in Jefferson City. A broad range of Columbia organizations have expressed support for expansion. Not only will the program offer health care coverage to more than 100,000 Missourians, it will have a significant boost to jobs and our local economies.

As a graduate student from MU, I am certainly aware of the importance of Medicaid expansion for young adults. More than one-half of uninsured Missourians are age 35 or younger. While the national health care law allows children to be on their parent’s health plan to age 26, there’s no guarantee families have a policy to put them on. Only 43 percent of Missouri small businesses even offer a health plan. Medicaid is likely the most affordable alternative.

I encourage our state-elected officials to support the receipt of federal funding to enact Medicaid expansion in Missouri. Otherwise, who pays? We pay. There would likely be additional budget cuts to education and additional hardship placed on the backs of college students in the form of fees and on the working class in the form of regressive taxes and cuts to vital services.

Please let Sen. Kurt Schaefer, Chair of the Missouri Senate Appropriations Committee, from Columbia know that we expect him to fully fund Medicaid expansion. I know that I have.  And, I encourage other voters ranging from the very young to the very old to do the same.

Curtis Edwards is a Columbia resident.

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Jimmy Bearfield April 4, 2013 | 7:14 a.m.

Curtis, where does the federal government get the money to pay for this expansion? Think about it.

(Report Comment)
Mark Foecking April 4, 2013 | 7:58 a.m.

The problem is, where's the money coming from to pay for health care for these uninsured people now? Largely from taxes (MU gets a certain amount from the state for indigent care, and the county supports a low-income health service) and higher health care fees. One way or another, we pay for it. The alternative is to deny them health care, which is basically illegal, and wouldn't get very far in any legislature.

I don't have a strong opinion on this because I don't think it will change anything about the basic problem, which is the high cost of health care. We already pay for it, just not through Medicaid.


(Report Comment)
Ellis Smith April 4, 2013 | 8:57 a.m.


Maybe we should change our national motto from the present Latin phrase (how many of us are proficient in Latin?) to this phrase, in plain English:


We claim to love our children and grandchildren, and I'm sure most of us are sincere. So how much more public debt are we going to shove off on them?

As someone who spent his career in the mineral industries I am familiar with the concept of occupational injury and disabilities. For example, Google "mesothelioma," for which I was on a watch list for years (from exposure to South African amosite asbestos; asbestos-related lung diseases can take up to two decades from initial exposure to actually manifesting themselves*). Also, dealing with extreme processing temperatures can produce both immediate injuries (direct burns and radiation burns) and long term health effects.

There are many "good and worthy" causes out there to be certain, but some fiscal discipline is needed when addressing them.

As with higher education, health care costs appear to be trending ever higher. The difference between now and when I was a student is that a number of health care situations (diagnoses and treatments) have significantly improved since then.

*- The same appears to be true for at least some man-made mineral fibers, yet one class of those fibers is pivotal in present eforts to enhance energy conservation and reduce carbon dioxide emissions.

(Report Comment)
Mark Foecking April 4, 2013 | 9:27 a.m.

Ellis Smith wrote:


It'd be great. I have no problem with that. The problem, for decades, and through several administrations and Congress' of both parties, is we've cut taxes without corresponding cuts in spending, and revenue/economic growth has not kept up with spending. It's one of those In - Out = (Accumulation) (parenthesis used in the accounting sense) things.

The cost of health care is a very complex issue, and fixing it would involve things that most patients would not feel comfortable fixing. Is it worth the money to get a second opinion about a clear cut, but distressing, diagnosis? At what point is an expensive surgery or treatment unjustified in a moribund patient? Why does a 2 hour operation cost hundreds of thousands of dollars, but would controlling that result in less availability of services? How much do we want to tell patients how they have to live (sugary drinks ban, anyone)?

There are several things we can do (bundled billing, coordinated care, etc.) to control costs somewhat, and some of this is being suggested and implemented in medical circles, but we're still stuck with the cost of health care largely being a result of patient and doctor's choices. Like the deficit, in which everyone wants to cut something but can't decide on what to cut, this may be a situation where we'll just have to accept higher taxes or higher health fees to pay for indigent care.


(Report Comment)
Ellis Smith April 4, 2013 | 12:45 p.m.


No disagreements, but I do want to point out one difference - in scope: my suggested "motto" is intended to apply to ALL federal programs, no matter what their subject matter or to whom federal funding is being given - including the DOD and NASA.

For example, agriculture: The original purpose of federal programs was to assist family farmers and ranchers, who continue to produce most of our foodstuffs, but this has morphed into "welfare" for conglamerates.

On the other hand, since the specific topic here is health care...

(Report Comment)
frank christian April 4, 2013 | 3:06 p.m.

"we've cut taxes without corresponding cuts in spending, and revenue/economic growth has not kept up with spending." Our Democrat controlled government has cut taxes and increased taxes, but spending has never been cut and nothing has come close to the increases in government spending. Democrat conceived, baseline budgeting and prez Obama have seen to that.

Ellis, just because our Agriculture Dept. has more open offices across the U.S. than Wal-Mart has storefront units, you feel it's too big?

(Report Comment)
Ellis Smith April 5, 2013 | 6:33 a.m.

@ Frank:

Please re-read what I actually said. My complaint concerns where I feel aid to domestic agriculture ends up: with those who need assistance the least.

There is some rationality for big ag corporations receiving federal subsidies: among their other functions they handle the logistics of agricultural exports.

Exports of agricultural goods, including tobacco products, and of bituminous coal* are two sectors where we actually have a positive balance of trade.

*- Is there some humor there? It's bad stuff, and we shouldn't burn it here, but apparently it's okay to ship it somewhere else. Maybe those folks are just going to LOOK at it and not burn it. :)

(Report Comment)
frank christian April 5, 2013 | 7:46 a.m.

"There are many "good and worthy" causes out there to be certain, but some fiscal discipline is needed when addressing them."

Sorry Ellis, I was addressing and agreeing with this sentence, as well as the first paragraph of your last to Mark, with a sarcastic (and I had hoped, humorous) tidbit.

(Report Comment)

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