Byron Schlomach’s recent editorial, “Standing on principle can be costly,” challenges lawmakers to stand up for a “principle” when making a choice about Medicaid expansion. He describes exaggerated worst case scenarios that fail to acknowledge the certain bleak reality that will occur if the Legislature does nothing to restore Arizona Health Care Cost Containment System (AHCCCS) coverage for childless adults.
A “principle” Arizona legislators might also want to consider if they fail to restore AHCCCS is the Golden Rule: treat others as you would like to be treated. Without legislative action, more than 50,000 low income childless adults will abruptly lose health care coverage on Jan. 1, 2014. This coverage will end even if they are in the middle of lifesaving treatment for conditions such as cancer, heart disease, diabetes or serious mental illness.
Dr. Schlomach is not a physician or clinician. He doesn’t have to look sick people in the eye and deliver bad news. He is also not a legislator. He doesn’t have to worry about how to answer the pleas for life-saving treatment from thousands of his constituents. Does anyone honestly believe more than 50,000 individuals will understand their lives are less important than the need to make a political statement against the federal debt?
Dr. Schlomach states in his editorial that Medicaid recipients are the “biggest users of emergency rooms” and that expanding AHCCCS will only make this worse. Does this mean that stripping health care coverage from vulnerable, low income Arizonans will cure their illnesses and reduce the number of times they need to seek treatment?
The difference in hospital utilization by someone covered by AHCCCS compared to someone who is uninsured is not as much an issue of visit frequency as it is the reasons why these visits occur. The uninsured without primary care coverage often show up at hospitals in far worse condition than the insured. It should be no surprise that the cost of this delayed treatment is exponentially higher. These costs are paid by all of us. But the uninsured pay an even greater price — having preventable or controllable conditions that without primary care can deteriorate quickly to become disabling or life threatening.
It is unfortunate that such critics of the AHCCCS restoration plan have the luxury of attacking the plan without providing a solution.
They also don’t have to be accountable to the more than 50,000 Arizonans who will lose their health care coverage on Jan. 1, 2014.
We should all be hopeful that we avert certain tragedy and ring in 2014 with a toast to the Golden Rule, knowing that we have treated our most vulnerable in the same way we would want to be treated.
— Anita C. Murcko, M.D., is an internist and chair of Health and Public Policy, American College of Physicians, Arizona Chapter.