Healthcare may not be a right but it is a necessity for society

Almost everyone is worried about healthcare. Kentuckians are pushing for reforms on a state level, but state administrations have limited ability to transform our system, since so much of the framework is mandated and fixed in stone by either federal law or federal dollars.

Many argue that universal healthcare is a moral imperative. Others state that we cannot afford the coverage and why should hard working citizens subsidize those who are unwilling to work or provide community service. But should denying healthcare be used to motivate social change? It is hard to win a moral argument, so let’s take a more pragmatic view.

Eligibility for Medicaid is largely based on income and family size. Some feel this program is a waste of our state tax dollars, but it is largely a federal, not a state tax dollar. For 2020, the federal government pays 71.82 percent of Kentucky’s Medicaid bill. With Medicaid expansion the newly insured are paid for at a rate of 90 percent after 2020.

From an economic standpoint, the injection of federal Medicaid dollars stimulates the economy. If Kentucky does not take advantage of this benefit, then your federal tax payments will just subsidize other states. The U.S. Government Accountability Office estimated that the administrative of Kentucky’s work requirement cost taxpayers over $270 million. Dollars which are expanding government could be used for patient care.

In addition, those without healthcare are more prone to develop severe and advanced conditions. When they then seek treatment in an emergency room, the hospital is federally mandated to treat the patient, resulting in shifting of their healthcare costs to the other paying patients.

We also live in a community and share retail and restaurant establishments along with public facilities. One of the most pressing issues is the emergence of highly contagious, drug resistant bacteria which can cause life-threatening disease. The lack of healthcare for some, then places us all at risk. This is what happened in Kentucky with insufficient funding of our Department of Health. Health departments are an important safety net for under-served populations including the homeless and drug users. Both of these populations were drivers of Kentucky’s Hepatitis A outbreak, the largest in the nation, which placed us all at risk. The same is true for non-treated MRSA infections and other drug resistant bacteria which are even deadlier and a greater risk to society.

However, much can be done to lower healthcare costs, such as addressing the high annual salaries of CEO’s which for major non-profits which have been found in one study to be $3.1 million. And if we are going to foot this bill, at least work with hospital boards to tie the chief executive officers and top hospital administrators’ bonuses to quality and cost improvements. Such a program could be incentivized through Kentucky’s Medicaid reimbursement system.

In addition, multiple studies have found that state strategies to hold down costs by limiting the number of healthcare facilities through the Certificate-of-Need (CON) process is ineffective and can even increase the cost of care. This strategy is anti-free market but appears to be embraced by both of Kentucky’s political parties. If Kentucky must embrace the CON, why not auction it off to the highest qualified bidder rather than giving it away. Many of which have been later sold with income pocketed by corporate entities. The raised funds could be used to match Federal Medicaid dollars so all facilities and not just the CON awardee could obtain an economic benefit.

The economic savings by reducing administrative overhead and auctioning CONs could easily sustain Kentucky’s healthcare system over the short-term. It is my belief that in the ensuing years the federal system will undergo radical change which may then require entirely new strategies.

Thus, lets promote a healthy Kentucky. If universal healthcare is not a right, it is a necessity, not just for the individual but for Kentucky’s society as a whole.

Kevin Kavanagh of Somerset is a retired physician and board chairman of Health Watch USA.