Harman: From long-term perspective, Medicaid expansion makes sense

May 1, 2013 


— Will our state plan for the short term or the long term?

Health and Human Services Director Tony Keck’s claim that having insurance is not a predictor of good health outcomes is transparently misleading. Why else would most people — including Mr. Keck and the governor — want health insurance, and be willing to pay for it? Even Republicans in Congress won’t give up their health-insurance plan.

Health insurance helps people manage their health in a timely, affordable way, leading to better outcomes. Not so when people ignore disease, injury and other problems until emergency care is needed. Who would ever want to navigate the paperwork maze of the health-insurance system if there were no benefit?

In the harangues by legislators, the governor and others, there has been little mention of benefit to the state — both short- and long-term — resulting from Medicaid expansion: healthier citizens. Preventive health initiatives, access to medications and routine monitoring and care can greatly reduce the incidence of developmental problems, chronic and debilitating conditions and premature death — all of which are costly to our state.

Healthier adults would be able to work and (it’s hoped) earn a decent wage, pay taxes and make productive contributions to their communities and the state economy. Healthier children would be able to learn and grow with fewer developmental/congenital conditions; fewer would die or be compromised by easily treatable childhood diseases.

As the ripple effects of preventive and routine health care are incorporated into the lives of South Carolinians, higher front-end costs of expanded health care will be replaced and supplemented by lower back-end costs of education, prevention and consistently managed care. The upward spiral brought about by better health practices will redound to the state many times over any costs to the state for Medicaid expansion.

As Ben Franklin explained: “An ounce of prevention is worth a pound of cure.”

Why are these obvious positive outcomes of Medicaid expansion being ignored, or vehemently opposed? I cannot understand why South Carolina’s fair-minded, intelligent and reasonable elected leaders have a problem with this concept. Could it be their lack of a minimally adequate education, as well as routine screenings and preventive care, when they were young?

Sej Harman


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