Reader's View: Idaho needs to figure out how to help all of its citizens

October 10, 2013 

We’ve all heard the swirling debate over health care — you can’t miss it over the airwaves or in your newspaper. But let’s focus on Idaho, and what our state can gain or stands to lose in the coming year.

It’s Mental Health Awareness Week (Oct. 6-12); however, mental illness is only a part of the health care problem. There are 80,000 Idahoans, mostly working families, who don’t earn enough to qualify for the subsidies to purchase policies in the new insurance exchanges. That is a large gap as reported by the governor’s work group last year. It makes Medicaid redesign worth doing.

Earlier diagnosis for both mental and physical illnesses when one has covered doctor visits would improve quality of life and longevity. First visits for a condition would not take place in the ER, but rather with the family doctor. People living with mental illness die in their 50s, on average, from treatable medical conditions. Dental benefits for this group could be restored so dental abscesses leading to hospitalization and even some reported deaths would not occur. Healthier adults are more productive and valuable employees.

The financial benefit to the state if we redesign Medicaid to include these citizens is huge, and has been thoroughly researched and reported to the Legislature. State Catastrophic Assistance and counties’ Indigent Fund, which spent over $50 million in 2011 and $70 million in 2012, would become mostly unnecessary as replaced by federal dollars. Our local tax dollars could be better spent elsewhere. If we don’t join the states who have accepted Medicaid for those in the gap, we leave over $40 million of yearly federal funds on the table, and our people uninsured.

The Department of Health and Welfare cut $6 million from annual mental health funding during the past recession. Treatment was only for those in crisis or jail, and there was not enough left for earlier treatment or adequate recovery support. Funds have still not been restored. Statistics from 2010 place Idaho 51st in mental health spending per capita. Children’s mental health funding was so poor, parents were advised to have their teenagers get arrested to get access to allocated prison funds for mental health.

Our elected representatives work very hard to allocate available dollars among all the pressing needs before them, and have to make difficult choices every session. The financial relief offered to the state budget by accepting Medicaid redesign would allow them some breathing room, and programs cut could be restored.

There are a few bright spots on the horizon. The new suicide hotline has been successfully up and running for a full year. The Suicide Prevention Action Network is rolling out a program for primary care physicians to help them recognize and obtain resources for a patient in need of mental health services. Law enforcement officers and first responders all over the state have completed training in crisis intervention for people exhibiting symptoms of mental illness. A new managed care company with a focus on recovery, Optum Idaho, has begun managing the Medicaid Behavioral Health program.

Do we want to pass up this opportunity and keep Idaho at the bottom in national health rankings, and sixth in the nation in suicides?

If you see value in helping the 80,000 obtain health coverage, please let your elected representatives know. They need to hear from you that you support Medicaid redesign, and that it’s time Idaho does the right thing for all of its people.

Kathy Mercer, R.N., of Meridian, is an Idaho state board member of National Alliance on Mental Illness (NAMI).

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