Sunday letters: Medicaid must be expanded

February 9, 2014 

— Rep. Murrell Smith, R-Sumter, was quoted recently as saying he rejects Medicaid expansion because “getting people insurance doesn’t make them more healthy” (“Haley’s State of the State: Campaign preview, too?”).

It is true that there is conflicting medical research about Medicaid’s effect on medical outcomes. But this is largely due to the fact that Medicaid patients are the poorest and sickest in the population: Therefore their care is expensive, and their complication rates are high.

But if there is no link between health insurance and health status, why do these legislators have insurance themselves? Why haven’t any of them had the courage of their convictions and dropped it?

Can our legislators not imagine having a relative with arthritis who needs a knee replacement but can’t afford it for lack of insurance? Surely watching him limp on his arthritic leg might persuade them that health insurance and health status are connected. Many South Carolinians go without needed health care, particularly those with chronic conditions such as diabetes, hypertension and heart disease, because they cannot afford it.

There are legitimate reasons to be concerned about Medicaid expansion, primarily cost. But unless an uninsured patient dies of his illness before he can get to an emergency room, all of us will bear the cost, through higher private insurance rates and other cost-shifting. Medicaid provides more than medical care; it provides dignity and peace of mind for our most vulnerable South Carolinians. We must find a way to fund an efficient and effective Medicaid program.

Paul DeMarco, M.D.


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