As a rural pharmacist, I am a part of the healthcare delivery system. I serve those covered under Medicare, Medicaid and private insurance. I know what people go through to make sure they have the drugs they need. Many of them juggle bills and food for their families with paying for the drugs and procedures they need.
The expansion of Medicaid in our state would mostly cover those who work hard and pay their taxes, but are not provided insurance through their jobs and cannot afford to buy single policy coverage.
It is time for straight talk about political implications hurting the people of Alabama. I am referring to the recent decision by Gov. Robert Bentley not to accept federal funding to expand Medicaid under the Patient Protection and Affordable Care Act - colloquially known as "Obamacare."
The reason for government is to help those caught in the web of circumstances beyond their control. While the PPACA's main thrust is cost control, and to prevent people from being punished for things beyond their control - being a woman, or having a pre-existing condition - it is also an economic boon to states which have not seen budget shortfalls like this since The Great Depression.
In a study conducted by The University of Alabama-Birmingham School of Public Health, David Becker and Michael Morrisey, both healthcare economists, say the state could see a $1 billion boon in new tax revenue:
"While this is a substantial increase in federal spending, it is new income flowing into Alabama Moreover, when physicians, hospital employees, pharmacists and other employees in the health care sector receive these new dollars, they spend them on gasoline and groceries and clothes. This second-round spending generates additional economic activity."
Read that last part again. The federal government will give us $11.7 billion, while the state's share is $771 million. Just the increased economic activity will bring in $1 billion in taxes. They say there's no such thing as a free lunch, and while we all pay federal income taxes, we should also all get something back from it. I hear Republicans whine every day about federal funding for studies to protect horned frogs, or for National Public Radio. Here is a chance for federal money to make a direct impact on the health and welfare of our citizens
while injecting money into our economy -- and we're turning it down?
After riding a wave of discontent and fear resulting from the drawn-out debate and fear-mongering over what is contained in the "Obamacare" legislation, my esteemed Republican colleagues hold all levers of governance in our state, and make moves in lockstep to stifle dissenting voices and ideas.
I believe in my heart that Robert Bentley is a good man. We served together in the state House of Representatives for eight years before I moved up to the Senate and he became our governor. He is also a medical doctor bound by the strictures of the Hippocratic Oath. It would seem to me that he would want to expand coverage to all of our states' citizens if doing so was economically feasible. So either the decision is raw political calculation -- the governor doesn't want a Tea Party challenger to his re-election campaign in 2014 -- hard-heartedness, or incompetence.
At the recent hearings on fixing Medicaid, it was revealed that in addition to an unknown $80 million hole in the Medicaid budget during FY 2013, the state Medicaid Agency has said they do not have the infrastructure in place to accept the money or to disburse it to the people who would be covered. A state agency not tracking its budget and unable to perform the service for which it was created should be a major scandal -- but it seems no one wants to upset the Republicans' apple cart.
In September the Republican leadership put forth an amendment to allow citizens to vote on transferring $437 million from the Alabama Oil and Gas Trust Fund -- a fund established to keep the state's money from oil and gas deposits in the Gulf of Mexico. The purpose of this amendment was to shore up the budgets of Medicaid and Corrections. The citizens passed this amendment, and I campaigned for it and personally voted for it. Alabama has the least amount of Medicaid coverage allowable by law. It seems to me that some of that money could go toward fixing the infrastructure needed to accept this vital money.
Giving working people basic health care coverage while pumping money all across our state at a 90% federal-10% state match is a no-brainer. I hope those with their hands on the levers of power have a change of heart.
William M. "Billy" Beasley, D-Clayton, serves in the Alabama Senate.


Musings for D-Day 2013

