Medicaid Expansion or Medicaid Re-Design - What will it be?

Personal accountability is written all over the Affordable Health Care Act. When it comes to Medicaid Expansion, how is personal responsibility factored in? Being responsible for one's own health is part of the health care cost equation, but not always easy to create. Accountability is normally viewed as being responsible - giving an explanation of your actions - to somebody for something; ideally this is to yourself. Personal responsibility and accountability is a complex notion when it comes to health. Unhealthy habits are one of multiple factors in disease. But health also follows wealth: on average, the higher on the socioeconomic ladder you are, the lower your risk of cancer, heart disease, diabetes, infant death and preterm deliveries.

Let's look at the top diseases in Idaho: Heart Disease, Stroke and Cancer. Specifically, 9 percent of Idahoans have been diagnosed with diabetes (many more go undiagnosed); 38 percent have high cholesterol, 29 percent have high blood pressure, 62 percent are overweight, 27 percent are obese, 82 percent don't eat 5 servings of fruit and vegetables per day and 21 percent don't get regular exercise. Do you see a theme here? Personal accountability for one's health begins with diet and exercise, but that is just part of the picture. People need coaches and incentives.

Every one of us has received some sort of support from a coach over the years - whether it be from a best friend, spouse, athletic coach, clergyman or teacher. There are times when we all need someone to help us get started, or to get back on track or stay on track! When it comes to behavior change models those of us in health care know that coaching and support systems are one of the key elements to successful accountability.

On Monday, Sept. 9 a team of local and state leaders will be discussing Medicaid Expansion and what it might look like in Idaho. Please join me at Pilgrims Market Education center to welcome Corey Surber, Director of Community Health Initiatives at St. Alphonsus RMC and with the Governors Workgroup on Medicaid Expansion, Dr. Dan Schmidt, M.D., also with the Governers Workgroup, Jai Nelson, County Commissioner and Mike Baker, CEO of Dirne Community Health Center to discuss what is being proposed, what Idaho stands to gain and/or lose and how personal accountability is factored into the expansion of Medicaid. The event will be from 6:30-8 p.m. at Pilgrims Market, 1316 N. Fourth St. in Coeur d'Alene - call (208) 676-9730 to RSVP.

SeAnne Safaii, Ph.D., RD, LD, is an assistant professor at the University of Idaho.