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Medicaid Expansion Studies: Follow the Money

  |   By: Jennifer Marsden     |   Letters to the Editor

There’s a new study out on Medicaid Expansion in Alabama from Troy University. It finds different conclusions from two prior studies from the University of Alabama and the University of Alabama at Birmingham. Articles on this study, and the new study’s authors, point out that the two prior studies were funded by the Alabama Hospital Association.

Of course, the authors deny any bias in their own research at Troy University’s Johnson Center, which is funded by the Koch brothers, a banking charity and the center’s namesake, Manuel H. Johnson, who held the Koch Chair for International Economics at George Mason University.

I was taught, and I am still learning how true it is, that in politics you must follow the money; this holds true in medicine and in research as well. It is likely true that the Alabama Hospital Association, hoping to encourage Gov. (Dr.) Bentley to expand Medicaid and thereby keep more of their member hospitals open, was happy with the results of the first two studies.

So what is the benefit for the Koch brothers, and other super-rich industrialists, if Alabama does not expand Medicaid? They have funded commercials (the creepy Uncle Sam puppet/doctor and many others) to convince young people not to get health insurance in a clear attack on the Affordable Care Act. They have funded other ACA misinformation efforts and support many other right wing goals. By reputation the Koch brothers want all of America to be like Alabama: low wage, nonunion, no benefits. Reversing the Affordable Care Act, if that were somehow possible, will save a lot of money on labor and pension costs.

Do the Koch brothers have health insurance? Do they see doctors? Have they offered to pay for the medical care of any of those who avoided signing up for affordable health care after the Koch brothers’ commercials convinced them it was a bad idea? Some may tell you that the Kochs had nothing to do with many of these expenditures, but if you follow the money, you see that many of them derive financial support from Koch funded front organizations. By the way, “Koch” (pronounced “coke”) is German for “cook” and we should not have to eat what they are cooking up!

Now, I am no economist, only a family doctor and Army veteran. But follow the money. Are the researchers biased? Does who funds your research determine your results? Certainly your politics (except maybe in mathematics) and prior research topics may determine who wants to fund your future research. I may be biased since more insured people would mean more paying patients.

Aside from money it’s frustrating when patients without insurance can’t afford to follow my advice. It’s also exasperating to hear about people who can’t even afford to see a family doctor. And it is heartbreaking to hear about people who, waiting for care they don’t yet have the money to pay for, die.

Follow the money for yourself. Do you have a small hospital near you that has closed or is about to close? Do you and all of your family and friends (anyone who might ask you for money if they need it for medical care) have affordable health insurance and medical care? If you do, did you know that you pay inflated costs in insurance and in taxes to help hospitals cover expenses when they provide emergency care to people who never pay for it? Do you or your relatives work in healthcare and now have to drive further (or take a job out of state) for work? Do we want to become a third-world country where people die if they don’t have money or health insurance? This is already happening to people in Alabama.

Whether expanding Medicaid is revenue neutral or not, costs us more right off, costs us in 3 years or even saves money, what these economists and Doctor Bentley leave out of the equation is that up to 300,000 more Alabama citizens will have health insurance. Again, follow the money. Do you believe that funded hospitals are a good idea in your county or is it better to support the ideals of the super-rich?

When I speak to Alabamians across the state, nearly all of them want to be sure that their families have the ability to obtain healthcare when they need it — regardless of how fat or skinny their wallets are. You should not have to follow your own money to help you decide to seek medical care; to decide if you should live or die. So I ask you: what is best for Alabama, what is best for you? I have personally and publicly asked Governor Doctor Bentley to expand Medicaid to cover these deserving hard-working Alabamians, expand healthcare jobs, and keep community hospitals in this state from closing.

That would be Good Medicine for Alabama!

Follow Jennifer on Twitter at @ALHouseDems

Dr. Marsden is a Family Practice doctor in Dale County. She is running for State House in District 93.