Don Millican: We have to breathe, even if it is ‘Obama-Air’ (Tulsa World)

By Don Millican

If oxygen was to be renamed “Obama-Air,” I am convinced that we in Oklahoma would hold our collective breath and refuse to breathe.

I get it. As a state, we do not like the guy. It is political suicide for any politician to even hint that he or she might endorse, accept or even tolerate one of the president’s policies.

But thankfully, I am an accountant, not a politician, and I tend to look at things from a dollars and cents perspective.

One thing I have come to accept is that, with the court challenges having run their course, with the super-majority required in Congress to override a veto and in the U.S. Senate to end a filibuster, with millions now signed up for insurance through the exchanges and millions more receiving the benefits of expanded Medicaid in states that have chosen to so expand, the Affordable Care Act — affectionately called “ObamaCare” — is not going away; just as Social Security, Medicare and Medicaid did not go away once they were fully implemented.

So now what do we do?

First, we need to accept the fact that, one way or another, we already have universal health care. When one of the over 500,000 uninsured Oklahomans has a health issue and arrives at a local hospital emergency room, either by law or a sense of moral obligation, they are not turned away.

Health care is then provided in the most expensive manner possible and the cost either cripples the finances of the family or, more often, is absorbed by the medical community. Of course, absorbing the cost of the uninsured leads to an overall increase in the cost of local medical care, which then leads to higher health insurance premiums for you and me.

The question, then, is not whether we are going to provide universal health care. We do that now, and we pay for it now through the increased cost of medical insurance.

The question is whether we in Oklahoma will continue paying for it twice.

We now pay for uninsured medical care once through higher insurance premiums, and we pay for it a second time by paying taxes to the federal government, taxes that were intended to come back to the state as reimbursement for the cost of extending Medicaid to uninsured poverty level individuals.

Thirty other states are receiving this reimbursement. We are not. We are not because we refuse to expand Medicaid.

How much are we talking about? According to the 2013 Leavitt Report, by refusing to expand Medicaid, we are turning down at least $10.5 billion over ten years — $10.5 billion of our tax dollars that are not being returned to our state.

Let that sink in.

Our governor says we can’t afford to expand Medicaid.

While it is true that, due to the state being required over time to begin paying 10 percent of the cost of newly eligible Medcaid Patients (approximately $600 million over the next 10 years), it is also true that expanded Medicaid will save the state a substantially similar amount by reducing costs for the Oklahoma Department of Mental Health and Substance Abuse Services, the Corrections Department, and the Oklahoma Department of Health as well as replacing costs already being spent by the state on uninsured care.

This does not even consider the economic benefit of infusing $10.5 billion into our local economy over the next 10 years.

Our governor says she wants to address the issue of uninsured medical care through an “Oklahoma Plan.”

We’re waiting.

If it is SoonerCare and Insure Oklahoma, it is not working. We continue to have over 500,000 uninsured using our emergency rooms for their primary care, and we continue to refuse $10.5 billion in our tax dollars being returned to our state.

We are still holding our collective breath, refusing to breathe.


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