Time to open presents

How exciting is this time of the year? Christmas is the season of gift giving. The time has come to gather round the proverbial Christmas tree and hand out the gifts. This year’s tree is a beautiful blue spruce. Oops, maybe not. I see now it’s a beetle kill tree from the Medicine Bow National Forest painted over. How nice of someone to keep us from thinking about that nasty climate change at this festive time of the year.

Well let’s get right to the presents. 

Ah look. The first one is for the Wyoming legislature. They say good things come in small packages. It’s a small bit of compassion. How wonderful. Legislators can certainly use it.

There are approximately 18,000 low-income people in this state who have been denied health insurance and access to healthcare only because they found themselves collateral damage in a partisan contest between Republicans and President Obama. With this little gift of compassion, perhaps enough legislators will be able to rise above all of that and actually take care of their constituents. I do hope the package is big enough.

Oh and here’s a gift for the taxpayers of Wyoming. It’s a gift from the Wyoming Department of Health. But the tag says, “Do not open until Medicaid is expanded.” If Medicaid is expanded, the taxpayers of Wyoming will receive a gift of ten-of-millions of dollars in health care, cost savings, and new jobs.

And who is this gift for? Oh, The Wyoming Liberty Group. It’s a beautiful new custom fly rod. Too bad most of them won’t be able to buy a resident fishing license for a while. But then with all that Texas money, they can afford the non-resident license. Good fishing. By the way, I hear some folks are actually taking your bait.

Did anybody get anything for WyWatch? These are the folks who use the Bible to foist their narrow religious views on everyone else. The problem is that their “views” come from a self-serving and erroneous reading of the Old Testament.

So this gift is perfect for my “Old-Testament-Christian” friends. It’s a Bible that includes the New Testament. That will certainly come in handy. I know they’re more comfortable using misinterpreted judgments of the Old Testament to lobby on behalf of inequality and discrimination. This gift will bring them out of their comfort zone.

Now that they have a Bible that includes the New Testament, they’ll be able to read the words of Jesus. “Love your neighbor as yourself,” for example.

Ah, here’s a package for State Senator Charlie Scott. It feels like a framed picture. Ah it is! Look. It is a photo of Charlie with his boyhood friend Methuselah. It says the photo was taken on Methuselah’s 969^th birthday, shortly before the Great Flood and a few weeks before Charlie was elected to his first term in the legislature. What a keepsake. The inscription reads, “Term limits are for sissies! Love, Methuselah.”

Here’s a package for CROW, the Conservative Republicans of Wyoming. Listen. Do you hear a ticking sound? Oh my. I see now. It’s not for CROW. It’s FROM CROW. Maybe we ought to have the bomb squad open this one.

Wait just a minute. Didn’t anyone get anything for the Governor? I thought about it but figured he’d already gotten his present on Election Day. Getting another four years to finally do something is gift enough. Wait there is one more present under the tree. It is for the Governor.

Shake it. Oh my. There are a couple of round things rolling around in the package. What could they be? Let’s read the note. Oh, it’s not what I thought. The note says, “For Governor Mead, two lumps of coal. You deserved a whole sack but EPA regulations allowed only for these two small chunks.”

I’d have bought a present for the voters of Wyoming but decided they have all they’re going to get and deserve whatever it is.

Merry Christmas everyone!

Uninsured are caught in the middle

The Cheyenne Regional Medical Center board of trustees voted to deny services to those who can’t afford full co-pays or deposits before receiving medical care. Shame on them.

CRMC trustee Marion Schultz voted against the policy. She doesn’t want people to think the hospital thinks more about money than people. It’s hard to avoid that conclusion as the hospital impedes traffic on Warren, building a huge new, costly edifice but cannot afford to provide adequate medical care to the uninsured or underinsured.

There is shame to go around. Most falls on the governor and the leadership of the Wyoming legislature. The politicians forced CRMC’s hand when they decided they’d rather be anti-Obamacare than pro-people. They refused an opportunity to expand Medicaid coverage to the uninsured, rejecting the entreaty of Wyoming hospitals that are losing more than 200 million dollars a year in uncompensated care.

The expansion of Medicaid coverage would have largely eliminated this shortfall and the federal government would have borne nearly all of the cost. Instead the uninsured will bear the cost. Medicaid would have saved not only that 200 million but ten-of-millions more in state general funds now spent on a hodge-podge collection of programs designed to help the uninsured.

But “the-governor-of-some-of-the-people” decided tea party myths about Obamacare were more worthy than healthcare for thousands impacted by his decision and the subsequent decision of the CRMC trustees.

The trustees took the responsibility off the governor and put it on the uninsured, voting to deny care to people who need care but cannot pay co-pays in full. Trustee chairman Joe Evans’ warned this fee is a barrier for people seeking care when needed. Still the majority voted to demand $180 from a new uninsured patient before allowing the first visit. That’s about three-quarters of a week’s pay for a low-income worker who is already in the red paying rent, transportation, utilities, and groceries. Those fees are unaffordable and will significantly increase the numbers of people in our community who will be unable to afford care.

Neither the governor, nor the legislature, nor CRMC are meeting their responsibilities. In the beginning CRMC should have done much more than it did to make their case to the legislature. There was a hesitancy to offend legislators on an issue of such political volatility. And now people who need care pay the price.

This decision has an adverse affect on public health. The uninsured and underinsured already experience significantly poorer health than those with insurance. The uninsured have much less access to care than those who are insured, and now that access is being further constricted in Laramie County.

People without health insurance have little preventive care. As a result, with cancer for example, studies confirm the obvious. Uninsured individuals are (1) less likely to receive cancer screening, (2) more likely to be diagnosed at an advanced disease stage and (3) less likely to survive than privately insured individuals.

The National Health Interview Survey showed that 54% of uninsured people between 18 to 64 years of age had no usual source of healthcare compared to just 10% of privately insured. The uninsured get sicker and die earlier than those with insurance.

Not having health insurance leads to additional costs. Without access to routine and preventive checkups, uninsured individuals develop serious health problems that are more expensive to treat without early detection. A lack of access to affordable medication also leads to serious health problems in the future that adequate insurance could have prevented.

Those statistics make the governor’s decision not to expand Medicaid and CRMC’s decision to deny care all the more unjust. In the end both CRMC and the state will spend much more money on much sicker people.

That’s not a surprise to CRMC. It’s always easier to focus on low-income families rather than speaking the truth to the governor about how his indecisiveness and the legislature’s callousness caused this. 

CRMC and its trustees should be advocates for, not impediments to, those who need medical services.

Wyoming legislators: All hat and no cattle

Not a week goes by that some struggling Wyoming family doesn’t hold a bake sale or a spaghetti dinner in a futile attempt to raise money to pay medical bills. If Governor Matt Mead and the other governors who joined in the lawsuit seeking the demise of the Affordable care Act have their way, those bake sales and spaghetti dinners may be all that the thousands of uninsured Wyomingites will have left to meet their health care needs.

Wyoming legislators proved they have nothing to offer on healthcare when they defeated the only effort the state has made to address this problem where they claim it should be addressed, at the state level. Despite plaintive calls for the protection of state’s rights under the 10^th Amendment, Wyoming legislators are all hat and no cattle when it comes to crafting legitimate alternatives to federal healthcare legislation.

They created a program called Healthy Frontiers. Its supporters touted it as an alternative to Medicaid. They enrolled 105 families who otherwise had no health insurance. Then they killed the program leaving the Governor scrambling to figure out what to do with those 105 families and what to do about his claim that the state can do it and the feds ought to mind their own business.

Senator Charles Scott, unlike many of his esteemed colleagues, has given it a yeoman’s try.  But the Governor and Senator Scott were forced to admit members of their own party believe the talking points have a priority over actually using state’s rights to do something. “One of the pushbacks on Healthy Frontiers was the notion that government should not be involved in health care,” Mead said.  One of the members of the Appropriations Committee where the program met its demise is Rep. Sue Wallis, who said, “Some Representatives are just uncomfortable with creating a local version of the federal mess.”

As Senator Scott noted, what we are doing now is not free, either of costs or of federal involvement. “Well, we are involved. We have Medicaid and nationally we have Medicare.  You have to be realistic and they aren’t.”

Scott was talking pointedly about the leaders of his own party, a party controlling all but 14 of the 90 seats in the legislature.  Speaker of the House Ed Buchanan, an opponent of Healthy Frontiers, made clear he had his sights set on taking it down though he offered no alternative vision. “Leadership really sent the message that we were opposed to Healthy Frontiers,” said Rep. Rosie Berger, chair of the House Appropriations Committee, turning the term “legislative leadership” into an oxymoron.

If the legislature refuses to take responsibility and exercise the rights they claim under the 10^th Amendment, that leaves only a couple of choices for people. Bake sales and spaghettis dinners or the Affordable Care Act, which those legislators who have no ideas of their own derisively call “Obamacare.” Even Governor Mead understands the last hope may well be the law his lawyers were in court this week trying to kill. “Whether Healthy Frontiers is the answer or not, we still have to look for answers,” Mead said. “We do need to try these things.” According to Mead the other options include a bill he signed into law authorizing state health care exchanges. That, by the way, is a significant element of what he calls “Obamacare.”

There have always been legitimate questions about whether Healthy Frontiers is a viable alternative to real healthcare reform. Yet it was something if nothing more than a legitimate effort at a state solution. The work of conservatives to kill it makes clear they are all hat no cattle on this issue but they don’t care much about those families holding bake sales and spaghetti dinners. Perhaps it is time for those struggling families to look at their own alternatives…at the ballot box this November.