Michael Thompson’s “Thoughts on Medicaid reform” (July 24 commentary) outlined 10 items that need to be considered in the Medicaid expansion debate. Unfortunately, it had several flaws. I would like to address three in particular.
In item 2,Ray Ban Wayfarer Size Chart, Thompson states that health care might be available through a free clinic. The reality is that Virginia’s free clinics had to turn away more than 10,000 potential patients in 2013 due to limited resources. One even has a bi-weekly lottery for available appointments.
This is why the Virginia Association of Free Charitable Clinics and their member organizations have been some of the loudest voices in promoting Medicaid expansion. Later, in item 7, he says that those clinics should be expanded — that would require tax dollars, just like Medicaid expansion.
Except that it would require state taxes in addition to the federal taxes that we are already paying for Medicaid expansion, but refusing to use.
In item 8, he notes that many hospitals in our state have significant profits. This is correct – however, the “billions of dollars” of profit he mentions are not equally spread around the state. While specialty hospitals in urban areas operate significantly in the black, Virginia’s small rural hospitals do not.
As he pointed out in item 2, “those who walk into an emergency room are required to be given medical attention.” In Virginia’s rural hospitals,Ray Ban Gold, 10 percent-20 percent of the patients do not have insurance and are unable to pay. I wonder if Thompson would expect businesses to stay open if 20 percent of their customers did not pay the bill. And if the hospital goes under, more people will lose their jobs and will be unable to pay for health care.
In item 10, Thompson advocates for the expansion of Remote Area Medical. Aside from the fact that this — like the expansion of free clinics – would require significant funding, he has misunderstood the purpose of RAM. The “R” stands for “remote” — RAM was originally developed to provide health care to Third World countries.
While those who receive treatment during RAM events are grateful for what they get, the care is only intended to be a short-term solution for those who are very desperate. The Washington Post described the recent RAM event in Wise County as “misery that shouldn’t exist,” pointing out that people are treated in “cow stalls and tents.”
The people who receive treatment through RAM very much wish that they had insurance to visit a regular clinic, rather than waiting in line for days (yes — days), sleeping in their cars. If they get in,Ray Ban Sunglasses India, there is no private exam room; they lay on one of the many treatment tables laid out in long rows where practitioners work elbow-to-elbow.
A young, healthy person might be able to wait once or twice a year to see a doctor at a RAM clinic, but probably wouldn’t bother to use it. The people who use RAM often have multiple chronic diseases: high blood pressure, diabetes, black lung, gum disease. They need regular, consistent care from someone familiar with their medical history.
Not a single doctor, nurse, dentist or other health care provider at RAM would agree with Thompson’s suggestion that expanding RAM events is a better idea than expanding Medicaid. This is why Stan Brock, founder and president of Remote Area Medical has consistently advocated for major health care reform. He knows that RAM-style clinics are not the answer.
In summary, Thompson states; “Health care access for the poor can be improved.” This is correct. The money to provide insurance to Virginia’s working poor is available through the federal tax dollars we are already paying. We just have to reach out and take it.