The Norman Transcript

Columns

January 15, 2013

Matter of compassion vs. politics

NORMAN — Thirty-three year old Jane is lying on the emergency room bed complaining of stomach pain. This is her third ER visit in two weeks. She is worried about losing her job from missing work.

We know what is causing the pain. Jane has a bad gallbladder that is full of stones. It is easy to fix. In the hospital Friday morning for surgery, home Friday afternoon, back at work Monday morning.

Like hundreds of thousands of hard-working Oklahomans, Jane has no insurance and no way to pay for the surgery. With two kids, she and her husband work at minimum-wage jobs for small companies that do not provide health insurance.

They would be covered by the expansion of Medicaid under the Affordable Care Act. Oklahoma has decided not to participate in this expansion, leaving Jane and her family in the lurch.

By now, you are well aware that Gov. Mary Fallin has decided that Oklahoma will not participate in expansion of Medicaid, which would provide health care insurance for all Oklahomans making less than 133 percent of the federal poverty level. For a family of four, this comes out to $30,657. The cost of health insurance for this family averages $5,167 a year. It is simply unaffordable.

I have no doubt that the governor made the right decision from a political standpoint. Emails and calls from constituents are overwhelmingly against the Affordable Care Act. Fact is, now it is the law, whether we like it or not.

I would have made the opposite choice from the governor. But then, again, my decision would not have been made based on politics but rather on the predicament many of my constituents find themselves.

Contrary to popular belief, people who would have been affected by the expansion of Medicaid are not deadbeats but hard-working Oklahomans trying to raise their children and make a better life for themselves. They have lower-wage jobs, without employer-provided insurance.

The federal reimbursement for expansion of Medicaid would have been 100 percent of the cost through 2016, and then gradually decreasing to 90 percent by 2020. This means the estimated cost to Oklahoma, if 75 percent of those eligible participate (some estimate that only 57 percent will sign up), would be $27 million in 2017 and increase to $56 million by 2020. This is a do-able number. 

Oklahomans will still have to pay federal taxes and penalties for not having health care insurance. With the governor’s decision, our money will now be used to expand the program in other states while our own citizens continue to be uninsured and lack access to care. 

Presently, Oklahoma hospitals receive supplemental Medicare money, called disproportionate share (DSH) payments to offset the cost of caring for the uninsured. These payments are going to be decreased or eliminated as a way to finance the federal share of the health plan.

Since the governor chose not to participate, Oklahoma hospitals will still lose the DSH payment and not be able to recoup the loss through the Medicaid expansion. Hospitals will face closing or raising prices to those with insurance, or paying with cash to make up for this lost revenue. 

I respect Gov. Fallin’s decision, but I work on a daily basis with good people who need but cannot get access to medical care. Right or wrong, my compassionate heart overrules my political mind.

 Rep. Doug Cox M.D., R-Grove represents Delaware and Mayes County in the Oklahoma House of Representatives. He is a practicing emergency room physician at Integris Grove General Hospital on Grand Lake.

For local news and more, subscribe to The Norman Transcript Smart Edition, or our print edition.

Text Only | Photo Reprints
Columns
  • Gas stations used to command loyalty

    More than 50 years ago, Ed Ruscha set off on a road trip from California to Oklahoma City and back. The young artist was driving to see his mother, who still lived in Oklahoma....

    May 19, 2013

  • Mothers today aren’t like early mothers

    Early mothers were known for their ability and willingness to sew for family as well as friends and neighbors. When clothes needed mending or someone needed a dress or a jacket, many mothers could always come through. “You have to stand ...

    May 16, 2013

  • A few ‘tells’ predict who will blow their money

    During Kentucky Derby week, gambling was at the forefront of my life. Along with non-stop activities in my home state of Kentucky, I spoke at a dinner for the Society of Settlement Professionals in Las Vegas. A film crew flew in from Rome ...

    May 14, 2013

  • Remembering George Nigh

    George Nigh was sworn into office four times and served longer as Oklahoma’s chief executive officer than any other person in the state’s history....

    May 12, 2013

  • Cleveland County needs district judges

    Politics makes strange bedfellows. Rep. Bobby Cleveland and I have had our disagreements, and likely neither wishes to share a bed with the other. Perhaps we’ve forgiven but not forgotten, but on the issue of an additional district ...

    May 9, 2013

  • New budget is fiscally responsible

    Over the course of the legislative session, the crafting of the state budget is the biggest task we face each spring....

    May 7, 2013

  • Testing limits, cadets

    When the Norman police sergeant insisted on taking me home after a night of binge drinking this week, my first thought was what would the neighbors think when the patrol car creeped into my driveway and my exit was from the back seat? ...

    May 5, 2013

  • Bangladesh factory collapse: beyond mourning and money

    Last Thursday, I went to the weekly meeting of Norman Rotary Club with Andy Rieger, the executive editor of the Norman Transcript. He introduced me and Rotarians responded with a waving hands and lovely applause. Just moments after I sat ...

    May 4, 2013

  • Legislature needs to take steps in criminal justice

    Most prosecutors and public defenders are sincere in their desire to dispense equal justice. Both sides are vastly overworked in many Oklahoma counties. These public servants are not the rich lawyers of myth. Pay for both sides is too low ...

    May 2, 2013

  • ‘Equality for all’ exemplified by attorneys

    The concept of “equality for all,” celebrated by Law Day 2013, is exemplified daily by attorneys working with the Norman-based Oklahoma Indigent Defense System. When judges determine that a citizen accused of a crime and facing loss of ...

    May 2, 2013