Mo. debate active about health care issues

Various methods to make health care more accessible have been proposed.

By Will Guldin

Published Feb. 12, 2009

Between economic hardships and a debate in Congress over a proposed stimulus package to help solve the problem, other issues can easily lose prominence.

While economic issues might be at the forefront of policy debates, the issue of health care continues to fuel debate across the country and throughout Missouri.

Gov. Jay Nixon's proposal to put approximately 60,000 people back on the state's Medicaid program, taken off during former Gov. Matt Blunt's term, could become a fiscal reality if the stimulus bill is signed into law.

The stimulus plan would provide billions of dollars to individual states, which could be used for their respective Medicaid programs.

"We would be remised as a state to turn our back on federal money," Rep. Steve Hodges, D-East Prairie, said. "If somebody offered you a hundred dollar bill to make your life better would you say, 'No thanks, I think I can make it on my own?' I don't think I would, but that's what some Republicans want to do."

Not everyone agrees that putting people back on Medicaid using the money from the stimulus is a good idea.

"If you look at the stimulus plan, if we're going to get one time money from the federal government and put people on the rolls, then next year when the money's gone we're going to have to them off the rolls again," Rep. David Sater, R-Cassville, said. "And that's the worst case scenario."

Some aren't sure that expanding Medicaid is a good idea even if more money was available to do so.

"I admire the governor's promises to return people to Medicaid, but I don't think keeping people poor is a solid, sustainable solution," Sen. Bill Stouffer, R-Napton, said in an e-mail. "We can't afford to give people incentives not to work."

Hodges said, as a representative for two of Missouri's poorest counties, he sees many single parents trying to support a large family. He said these individuals generally make just enough not to qualify for assistance, but not enough to provide for their family.

Hodges said this encourages them to stop working in order to receive government assistance. He advocates for expanded care so these individuals don't have to sacrifice working in order to get the assistance they need.

Hodges said this basic care is something the poorer areas of Missouri lack.

"Many of them don't go to the doctor for check-ups, and if they get sick and they don't have a Medicaid card, you know where they go?" Hodges said. "They go to the emergency room. And emergency rooms bills are expensive."

Hodges said while many Republicans disagree with him, a compromise must be reached.

"We're going to have to convince the Republicans in the legislature to work together with us as part of a bipartisan effort to make the lives of people in Missouri better," he said.

Sater said health care in the state is a problem that needs to be addressed, but said the way to do it was through preventative care and not through government spending on Medicaid.

"We need to spend more money on preventative health care, things like smoking cessation, making sure everyone on Medicaid has a health care home, and a family physician," Sater said. "That keeps people healthier in the long run."

Stouffer said that Medicaid was not the best way to solve these problems.

"More government intervention and funding isn't always the answer," Stouffer said. "We need to introduce competition back into the market place. Most importantly, we need personal responsibility. Folks who don't have to pay for it go to the ER just for a headache. That costs all of us."