We cannot afford to not expand Medicaid

In response to a letter to the editor by Dr. Matt Bailey stating that we cannot afford Medicaid expansion, I completely disagree. We cannot afford doing without Medicaid expansion. More specifically, the hospital where Bailey is a board member can certainly not afford to do without Medicaid expansion.

Let’s look at the numbers. According to North Valley Hospital’s annual report, last year 30 percent of their revenue, or $19.26 million, was unpaid (a combination of charity care, bad debt and discounts). With Medicaid expansion, a good portion of this money would have been reimbursed to the hospital.

How many business can survive when 30 percent of goods and services cannot be paid? This is par for the course for not-for-profit hospitals. The Montana Hospital Association keeps a running count on their Web site of the cost to Montana from inaction on Medicaid expansion since Jan. 1, 2014. It’s $585 million and counting. Check out their Web site and open the link to “Montana Medicaid: Frequently asked questions.”

MHA and just about every hospital in the state and the nation supports Medicaid expansion. This is not a money grab or an attempt to bankrupt the nation. This is completely about keeping the doors to health care open, not passing on these uncollected revenues to the folks who can pay their medical bills either through insurance or private pay, and most importantly ensuring quality of care.

Whether we pay for it in the form of taxes, higher insurance rates or higher health-care costs, ultimately we will pay for the health care of those who cannot afford it. By law, not-for-profit hospitals cannot refuse care regardless of whether the patient can pay.

What Medicaid expansion can do is provide routine health care for those who otherwise would not seek it until the last possible minute because there is no way to pay for it. This situation ultimately results in the most excessive cost to the health-care system. This is the population that ultimately ends up in the hospital, with serious and expensive health-care complications and no way to pay because Medicaid was not available.

We are not talking about people who are trying to get a free ride in life. We are talking about the working poor, those trying to make ends meet, single parents working multiple jobs, the 55-year-old guy who was laid off last year, the individual who was injured and cannot work. I can go on.

The broader argument about a balanced budget and what the nation can and cannot afford is much larger than this. If we want to have a discussion about our long-term financial health let’s look at everything, military spending included. In the meantime, perhaps we should ask ourselves this simple question. Is health care in America a right or a privilege?

Joe Grabowski, of West Glacier, is a North Valley Hospital employee.