COLUMBIA — The problem is far from simple — so far from simple that the Affordable Care Act may or may not be a solution. If Washington University health economist Timothy McBride is correct and 13 percent of the state’s population is uninsured, or some 710,000 people, why are our legislators still screwing around?
And, although Lt. Gov. Peter Kinder is telling us not to buy insurance through "Obamacare," maybe others in the GOP are seeking a state solution — something the legislators rejected last session. The expansion of Medicaid.
State Sen. Gary Romine, R-Farmington, chaired last week’s hearings concerning Medicaid reform and expansion. I do not envy his position, faced with the ultra-right wing anarchists who see Medicaid and the Affordable Care Act as the evil twin, socialist systems that breed dependence on the government, and the rest of us who see both programs as being able to provide much needed health care to at least 300,000 Missourians who now fall in the cracks.
Not that health care is not available. Family Health Center, Boone County’s clinic, provides what I consider superior health care to the under- and uninsured, many on a sliding affordability scale. And who is paying for this? The taxpayers of the state. If the individual is sick and there is no clinic available, then it is to the emergency room. And when the person cannot pay the bill it falls to the insurance companies who insure you and me. It's one reason our health insurance premiums are so high.
How high? We spend more per capita on health care than the next 10 countries combined, and some can say we are not getting our money’s worth. The World Health Organization ranks the United Sates 37th in the world for quality of health. In fact, the nations with the best health care are those which have some form of universal health care coverage, whether it is a single-payer system or one fashioned as the Affordable Care Act, utilizing private insurance companies in an open market.
I have written before that one of the reasons for poverty in the United States is the loss of manufacturing jobs. That loss of skilled and unskilled labor opportunities has resulted in many more Americans lacking health insurance. As more uninsured Americans' use of clinics and the emergency rooms for basic health care increases, the more insurance premiums go up. The more the premiums go up, the less likely employers are to offer health insurance to their employees.
It is a vicious cycle that will stop only when insurance — affordable insurance — is made available to everyone regardless of an ability to pay. That is the cycle the Affordable Care Act is meant to break. That is the cycle that the expansion of Medicaid is meant to break.
We have socialist systems already in place: Medicare, Medicaid, the Department of Veterans Affairs and other programs that work very well. No program is 100 percent perfect, and someone will always find a method to “beat the system.” My years in the Colorado Division of Insurance have proven to me the unlimited imagination of people who want to “beat the system.” We tend to hear the bad stories not because they are so bad, but because they are so rare — like airplane accidents or train derailments.
It should not be a question as to whether to provide insurance to the uninsured, but how soon we can do it. And not just health insurance but dental insurance as well. Dental emergencies account for more than 41 percent of all emergency department visits in the U.S., and the number has doubled in the past 10 years.
Can you imagine what life would be like if the United States were in the top 10 countries for quality of health and dental care? Could you imagine the thriving economy, the lower unemployment and underemployment rates and the feeling of well-being we have not seen since the 1960s?
While we are reforming our health care laws, let Missouri take the lead and require a standardized health insurance claim form so medical offices can get back to providing health care and not searching through the files to get the correct form with the correct company with the correct coding.
Expanding Medicaid, adding dental insurance to the Affordable Care Act and standardizing the claims form could go a long way to reducing medical and dental costs and keeping Missourians healthy, employed and productive.
David Rosman is an editor, writer, professional speaker and college instructor in communications, ethics, business and politics. He writes a weekly column for the Missourian.