“I will prevent disease whenever I can, for prevention is preferable to cure.” So says the Hippocratic Oath that I, along with all physicians, swore to uphold. It guides my practice as a pediatrician, and it guides my staunch support for expanding Medicaid.
Prevention goes by the wayside for people who cannot afford health insurance. When pitted against paying rent, putting food on the table or buying gas to get to work, going to the doctor often does not make the cut. For too many North Carolinians, these are the real-life choices that they face. I meet many of them when I care for their children. They are farmers, restaurant workers, construction workers and child care teachers who are working hard, but not earning enough to afford health insurance for themselves.
Like all of us, though, people without health insurance still get sick. And when they do, there is usually only one place that won’t turn them away — the emergency room. What could be a routine visit at a doctor’s office becomes a crisis with an exorbitant price tag in the emergency room. It’s the asthma attack that could have been controlled with medicine. It’s the stroke that could have been prevented with blood pressure medicine. It’s the stage IV cancer that could have been diagnosed at stage I.
This is the reality for many of our neighbors. Our state has one of the highest rates of people without health insurance. Only eight other states are worse. It is literally killing us. It doesn’t have to. We can look to the 37 other states that have expanded Medicaid to see what happens when you give people access to health insurance. Here’s a sampling of what research has shown in states that expand Medicaid:
• More babies live to their first birthday.
• Fewer women die during pregnancy.
• People experience improved mental and physical health.
• The share of people with uncontrolled diabetes and hypertension drops.
• The number and severity of hospitalizations for several conditions drops.
• People have earlier cancer diagnosis and improved access to cancer treatment.
• There are fewer deaths from cardiovascular disease.
• There is a reduction in emergency room use and an increase in use of preventative care services.
I want these same benefits for North Carolinians. As it is, we are paying about $1.7 billion per year in federal taxes for 37 other states to provide health insurance to their residents. That amount is the same whether or not North Carolina expands Medicaid. So why not help 500,000 North Carolinians, including 4,400 people right here in Watauga County, access health insurance?
Instead, we have become paralyzed by politics. It saddens me that implementing what is now a proven policy to improve people’s health has become partisan in our General Assembly, particularly when it is not a partisan issue for those of us that elect them. I am a Republican. I, like the majority of Republican, Democrat, and Independent voters in our state, support Medicaid expansion. (See poll by NC Fund for a Conservative Future.)
I began by sharing a sentence from the Hippocratic Oath. The line that follows it says, “I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.” I urge our lawmakers to do the same and expand Medicaid.
Greg Adams, M.D.