Eric Fruits is outraged by the cost of the Oregon’s Medicaid expansion and its impact on the state’s budget (“Oregon must reject Medicaid expansion for state’s fiscal health”, Jan. 27). I’m guessing that’s because he either never gets sick, or more likely has a comprehensive health insurance plan through his employer that covers both him and his family. But the cost of providing similar coverage to 25 percent of our state’s most vulnerable citizens is obviously a budget buster and has to go.
In countries where health care is not viewed simply as one of the perks of employment, governments somehow manage to find a way to provide a basic level of health care for all. In those places (i.e. the rest of the industrialized world), programs analogous to Medicaid are not viewed as “entitlements” but as a fundamental right. Might I suggest to him that the reason they do this is because it’s the right thing to do.
Dr. Fruits clearly looks forward to repealing the core provisions of the Affordable Care Act as if that will aid and abet the private health insurance industry. In fact, repeal of the individual mandate (if you’re going to repeal, why not go all the way?) is very likely to restrict the private insurance market. Once millions of Americans are purged from Medicaid expansion programs, they will have to resort to backchannel ways of accessing care like expensive emergency room visits. Others will be unlikely to be able to afford anything other than low premium-high deductible plans. This is basically insurance that you never want to use which results in putting off cancer screenings and other preventive care. And just like before Obamacare became the law of the land, they will be one catastrophic illness away from financial ruin and personal bankruptcy.
James Santoro MD, MPH
West Linn
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