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Medicaid expansion right move for Virginia

Date published: 5/12/2014

I have read Speaker Howell's objections to expanding Medicaid in Virginia. The three ways he offers as an alternative to achieve this end should be examined.

First, he states we should not rely on federal dollars. Interesting, since Virginia is the prime recipient of federal money and has been for many years. Without federal dollars for government contracts among many other payments, our state would be severely strapped economically. Yet we continue to treat Medicaid money differently.

Does Howell think Virginians would be happier to ante up more taxes to fill the gaps in Medicaid? The federal money is there. Use it or it goes away to be used elsewhere.

Howell says it should target coverage to those who need it the most. He's missed the target for 400,000 uninsured Virginians. They are not all "welfare queens." They are honest Virginians who are out of work or are working poor.

Perhaps we should put in a call to Doctors Without Borders for help! A mother with a sick child is not concerned with where money to see the doctor comes from. Stop blaming the poor for being poor!

Finally, he says coverage should be based on principles utilized in the private market. We should emphasize cost sharing, health and welfare approaches and competition to keep costs down. Wonderful! Howell must have read the Affordable Care Act and plucked this right out of it!

I am saddened that he doesn't realize what damage he does by his well-intentioned but wrongheaded opposition.

The Medicaid money that he refuses will go elsewhere to the many states that value its worth. It will not go to the neediest poor. This doesn't prevent us from taking steps to weed out waste, fraud and abuse in the system.

Recently, "60 Minutes" showed a segment on the suffering of people who cannot afford medical insurance. Where? Right here in Virginia! I was shocked and appalled. Two dedicated physician assistants try to cover Virginia's Third World Appalachia in a run-down, converted bus. They use meager resources that are donated or they are able to scrounge. They work hideous hours in all kinds of conditions to do an impossible job.

Wouldn't it be better if these destitute patients had health insurance? They could see a nearby doctor or go to a local clinic to avoid suffering the abomination of medical complications from treatable and preventable scourges such as diabetes, cancer, heart attacks and strokes.

When they finally are forced to go to the ER, their problems are advanced and critical. This necessitates the most expensive and complicated use of medical services for which we, the people of Virginia, must pay. Here is the most egregious waste.

If I were Speaker Howell, comfortable with my own state-guaranteed health insurance, I would have difficulty looking at myself in the mirror. I beg him to try to undo some of the damage to the living that is already too late for many of the dead.

Ronald A. Apter, M.D.