I’ve read and watched with interest in recent days as legislators, health care providers, community leaders, columnists, editorial boards and citizens have reacted to the Primary Care Access Plan that I unveiled Jan. 7.
Responses have run the gamut from “It’s not enough — just expand Medicaid” to “We shouldn’t do anything but focus on repealing Obamacare.”
Despite what seems to be an immutable impasse, it certainly is a conversation worth having, and I’m glad we are having it. But critics seem to be missing the point of the proposal that Director Dick Armstrong and his team at the Idaho Department of Health and Welfare crafted specifically for Idaho. The fact is that the PCAP option — or something very much like it — is all that we can reasonably hope to achieve right now in the context of Idaho’s political environment.
That difficult but unassailable truth is occasionally referenced by commentators. However, so far it has been quickly dismissed as an illegitimate and weak-willed excuse for advancing an admittedly limited public policy initiative. Like a horse that starves waiting for oats while grass grows thick all around, they couch the debate in absolute terms — short-circuiting constructive discussion with a false “either/or” choice between expanding Medicaid and doing nothing at all.
The latter position has carried the day so far, and I will stick to the commitment I made to legislative leadership in June 2010 not to act unilaterally on any Obamacare-related issue. Yet I believe it is my responsibility to build support for homegrown solutions — not government entitlements but rather the kind of cost-effective solutions that involve building public-private partnerships and which reflect the independent, self-reliant character of Idaho citizens.
Our public discussion must recognize that PCAP is not short for “panacea.” It is intended instead as a point of departure for a longer-term effort to improve access to primary and preventive health care, especially in our underserved rural communities. It’s based on a patient-centered “medical home” model focused on connecting patients with a health care provider who supervises their long-term primary and preventive care.
The need is undeniable. Approximately 78,000 people in Idaho fall into the “gap” — the working poor who do not qualify for Medicaid, people who fell through the Obamacare net. But rather than growing the entitlement culture, PCAP embodies goals and priorities — including personal responsibility — which we have been independently developing here in Idaho since I took office in 2007, pre-Obamacare.
Haven’t we gone long enough without addressing the issue?
The point of this column, and of my administration’s work during this legislative session, is to make it clear to everyone that PCAP is not the final word on providing Idaho citizens with the opportunities they need to keep themselves and their families healthy. But it could be a great start.
Otter is serving his third term as governor of Idaho.