Progressive Voices

Politicians should provide straight answers on health care

Our community counts on Medicaid every day. That’s why we need straight answers from politicians about proposals to gut Medicaid.

When our parents can no longer live independently on their own, Medicaid provides the nursing home or home care they need. When neighbors living with disabilities need wheelchairs or prosthetics, Medicaid allows them to continue contributing to our community. When parents can’t get or can’t afford private health insurance, Medicaid provides the preventive care their kids need to stay healthy, and it lets them see the doctor when they get sick or injured. And when families lose their jobs, Medicaid protects them from becoming uninsured.

Medicaid’s federal-state partnership also protects North Carolina jobs. Clinics, doctor’s offices, hospitals, and other health care businesses count on Medicaid for a dependable source of revenue that supports local jobs.

But right now Washington politicians are considering proposals that put our families, friends, neighbors, and local jobs at risk. Making Medicaid a “block grant” or imposing a health care “spending cap” would set arbitrary limits on federal Medicaid investments. These proposals do nothing to bring down health care costs; they just shift costs from the federal government to states, and then on to us.

If the federal government simply stops paying for care above an arbitrary cap, states will have few choices. They can make kids, seniors, families, and people with disabilities uninsured –raising everyone’s insurance premiums when the uninsured are forced to seek expensive emergency room care. They can cut payments to doctors’ offices, hospitals, and nursing homes — putting both care and jobs at risk. Or they can cover the difference by raising our taxes or cutting critical services like schools and police. Either way, we pay.

There are better ways to control health care costs.

America’s health care law, the Affordable Care Act (ACA), is a good start. People with multiple long-standing health problems, like high blood pressure and diabetes, cost the most to treat, because their doctors don’t communicate with each other. The ACA rewards doctors for reducing costs by coordinating care. Nursing homes are much more expensive than caring for seniors or people with disabilities in their own homes. The ACA increases Medicaid payments for states that make it easier for those who can’t live alone to get the quality care they need more cost-effectively, through assisted living facilities or care in their own homes. The ACA invests in putting more primary care physicians on the job, so they can catch problems early and avoid expensive hospitalizations. And the ACA cracks down on Medicaid fraud, improving policing and enforcement against provider and drug company overcharges.

We can and should do more. We should crack down on pharmaceutical company abuses that keep more cost-effective generic medicines off the market. We should close a loophole that lets drug companies charge Medicare more when seniors on Medicaid need drugs. We should accelerate and expand efforts to prevent costly medical errors or hospital-acquired infections. And we should adopt a budget that includes common-sense ideas like tax incentives to reduce consumption of sugary drinks — cutting our budget deficit and avoiding costs from illnesses like diabetes and heart disease.

These ideas will not only bring down Medicaid costs, they will actually drive down health care costs for all of us.

And unlike block grants and spending caps, they will actually improve care for the kids, seniors, and disabled residents who depend upon Medicaid every day, while protecting health care businesses and local jobs.

With so much on the line, North Carolina families need straight answers from the politicians about the consequences of proposals to weaken Medicaid. And we should all demand that they exhaust every other viable option before they even consider policies that would put our health and our economy at risk.

Adam Searing is the Project Director of the North Carolina Justice Center’s Health Access Coalition and Robert Restuccia is Executive Director of Community Catalyst, a non-profit national consumer health advocacy organization based in Boston.