Guest Opinions

Otter health plan no substitute for Medicaid expansion

For weeks I have read your substantive coverage regarding Idaho Sen. Dan Schmidt’s plan to close the Medicaid gap in our state using federal tax dollars compared to Gov. Otter’s Primary Care Access Plan to attempt to increase primary care access alone using state monies.

The latter does so without coverage for medications, hospitalizations and procedures, unlike Sen. Schmidt’s plan. What I have been surprised by is that these two plans are compared together as alternatives for one another. In reality, the Primary Care Access Plan is unfortunately little more than an implausible attempt to address what polls say Idahoans overwhelmingly want in this state: improved access to health care.

Sen. Schmidt’s plan accomplishes improved health care coverage by accepting federal funding and providing complete health insurance to the 78,000 Idahoans living without it. Gov. Otter’s plan provides $32 a month to those same individuals to try to find a primary care doctor (we have a large shortage of them in Idaho) to essentially provide charity care, as the coverage is provided at a loss to clinics. That doctor, if the patient can find one, would then offer the patient a view of all the care that they need, but have no insurance to obtain.

I have seen that scenario play out far too many times in the hospital to my uninsured patients. Eventually, those patients become sick enough to get care, and are admitted to the hospital to receive it. Sometimes, those illnesses could have been less severe, less life-altering, if treated earlier.

The debt from a single hospitalization can lead anyone in average financial standing into bankruptcy when they don’t have health insurance. Health care debt is the No. 1 cause of bankruptcy in our country, and I am certain that uninsured patients I have cared for have been forced into it. Sen. Schmidt’s plan addresses this; Otter’s plan does not.

The Primary Care Access Plan offers no substantial change from the current system we rely on for the uninsured: attempts to supply health care to the uninsured via charity, which I have seen fail time and time again. I believe Gov. Otter to be an intelligent, thoughtful gentleman with his constituents at heart, though I do not expect him to be an expert in health policy. I wonder if he has been led astray by his health policy advisers, as this proposal provides no considerable improvement in health care access to Idahoans.

We must stop treating these proposed policies as alternatives to one another. We must call the Primary Care Access Plan plan what it is: window dressing.

Adam Balinger, MD, MHA, of Boise, is an internal medicine physician.

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