To be poor and without health insurance in Ohio is to walk largely out of sight while waiting to feel the many impacts of unaffordable and inadequate health care, ill health and societal indifference. It is where hundreds of thousands of our friends and neighbors walk.
The results of these inadequacies are brutal: Cancers are diagnosed later. Chronic diseases are more likely to cause preventable complications such as heart attacks and amputations, and families are more likely to be bankrupted by their medical bills. As a result, those in our community “family” who cannot get health insurance are more likely to die early for lack of adequate care.
That’s not the way it has to be. On Monday, the State Controlling Board has the chance to change that ugly travesty in the world’s richest country, by expanding the Medicaid program for the working poor and mentally ill populations of Ohio. Expansion would help 275,000 Ohio residents gain access to health care.
It’s easy to forget what “access” to health care means to patients. As a physician, I know it means access to the blood pressure treatments than can prevent crippling strokes, the diabetes treatments that can prevent blindness, and the depression treatment that can turn lights back on in the human soul. It is access to medical treatments that enable some chronically ill people to work, stay out of the ER and contribute productively to society.
Medicaid expansion is supported by a broad coalition of Ohioans from across the political spectrum including Republican Gov. John Kasich, conservatives, physician groups, liberals, businesses, local chambers of commerce, faith-based leaders and others who say this should not be an issue of politics, but of basic human decency and justice, sound social policy, and the good business sense to make sure ill health does not prevent people from working and supporting households and communities.
Advocates know Medicaid expansion would benefit people who are employed and have no access to health insurance. Expansion could significantly improve the lives of cashiers, cooks, health-care workers, truck drivers, farm workers, waiters and waitresses. In other words, the people who would be helped by the expansion are not “them,” they are us.
Advocates are aware that individuals with Medicaid are better off from a health perspective than those who have no insurance. A recent Ohio State University John Glenn School of Public Affairs study “Medicaid Outcomes: Better than being uninsured and comparable to private coverage?” systematically debunks many of the myths about Medicaid insurance put forward by those against expansion. Medicaid can literally be a lifesaver for many uninsured adults.
I encourage the Controlling Board on Monday to vote in favor of expansion to help 275,000 of our friends. Thereafter, I support our General Assembly members placing energy into redesigning the Medicaid program to ensure it is more affordable, effective and sustainable. Incentives should be embedded into an expanded program to encourage patients and providers to spend taxpayer dollars more wisely. I also desire an expanded program that focuses on getting more patients into primary care, which has shown again and again to be the foundation of good, preventive and cost-effective care.
Ohio has an opportunity to ensure a greater number of the working poor and citizens with mental illness gain access to health coverage. Doing nothing while thousands suffer avoidably should not be an option for our state. We can do better by these individuals who work and live among us.
In the meantime, I hope you and your family avoid the pitfalls that plague the poor and uninsured who feel the inadequacies of our health-care system. For there, but for the grace of God, go all of us.
Steele is chief medical officer and senior vice president of Summa Health System.