The human cost of Idaho's Medicaid gap

The time has come to shift the argument about Medicaid beyond the dollars that would be saved with expansion to the ongoing human tragedy occurring in our state.

While the truth is that Medicaid expansion will save the state hundreds of millions of dollars, that reasoning has not resonated with our legislators and governor.

Perhaps a basic reason the Legislature has resisted Medicaid expansion was stated by Sen. Brent Hill in a recent interview. Legislators will not want to expand medical coverage, then see federal funding for it dry up if the Affordable Care Act is ultimately dismembered. He stated, “We just don’t want to be in that position.”

The hope among our legislators that the ACA will be dismantled after finally bringing health care to 32 million Americans is about as likely as dismantling Social Security or Medicare. The idea that the ACA will be discarded is a specious argument.

Then we have Bart Davis, Senate Majority leader, taking a wait-and-see attitude, telling me we’ll just have to see what the “political appetite” is of the Legislature, as though whether to expand Medicaid is akin to picking dinner off a menu.

Perhaps the more sinister, but truthful argument as to why our legislators refuse to expand Medicaid was stated by Ronald M. Nate, now a legislator. He wrote, “The long-term dependency of new recipients is too high a price to pay for temporary budget fixes.”

I strongly suspect Nate has always had health insurance. Sitting in that comfortable position and claiming that access to care for the working poor and disabled will somehow result in them developing a character flaw is both arrogant and paternalistic.

So the time has come for us to focus on the real issue: Idahoans are suffering and dying as a result of the Legislature’s intransigence. The Legislature is not only costing the state millions of dollars, it is costing lives and imposing untold suffering on 170,000 Idahoans.

Since Idaho has the largest percentage of minimum wage workers in the country and the second-lowest average gross wage, more Idahoans would benefit from Medicaid expansion on a per capita basis, with more lives saved, than any other state.

The number of lives lost each year that we fail to expand Medicaid is unconscionable. Estimates range up to 811 lives lost each year in our state. A conservative estimate is 311 lives a year based on a New England Journal of Medicine study, extrapolated to our population. That’s nearly one life a day and about three lives a year attributable to each of our legislators.

This suffering and loss of lives must not be tolerated any longer. For those of us on the front lines of medicine who daily deal with the fallout of the Legislature’s inaction, our frustration has turned to anger. I, for one, can no longer be civil about this conversation.

The Legislature is killing Idahoans. By refusing to show any compassion or humanity and by adhering to their pointless sanctimonious ideology, they are inflicting suffering and death on Idahoans on a daily basis.

We must make it clear that as citizens of this great state, we will no longer stand idly by and allow the Legislature to refuse accountability for inflicting suffering and death on our neighbors. The time has come to move past the dollars and cents of this issue. The time has come for us to take care of each other.

Dr. Krell is Medical Director of Critical Care at Eastern Idaho Medical Center. He can be reached at kkrell1@gmail.com.