Posted by: Allison Rice | February 20, 2013

HIV physicians on Medicaid expansion — echoed by Gov. Kasich of Ohio

As the General Assembly works out the last details of the “No NC Insurance Exchange – No Medicaid Expansion” bill (aka, “Just say no to Obamacare”), several North Carolina HIV doctors have been speaking out.  Two UNC physicians, both professors and researchers, have opinion pieces this week.  And far away in Ohio, Governor Kasich sounds the same note.

Dr. Charles Vanderhorst returned from treating HIV patients in Africa to find the Medicaid expansion-killing bill well on the way to enactment.  His op ed in the Tuesday, February 17 Raleigh News & Observer was aptly titled Shutting the doctor’s door in tarheel faces.

As a clinical AIDS researcher in South Africa and Malawi, I know firsthand what it looks like when societies with over-burdened health systems can’t provide basic care for their citizens. And yet when I arrived back in North Carolina this month, I was shocked to learn that leaders in our own state are now doing everything in their power to take us down those same catastrophic paths.

By willfully rejecting an expansion of Medicaid for thousands of hard-working North Carolina families, Gov. Pat McCrory is relegating many of them to the same fate as many of my patients in Africa – dying needlessly for the simple lack of appropriate preventative care.

Dr. Vanderhorst’s colleague, Dr. Adaora A. Adimora spoke out in yesterday’s Charlotte Observer.  Dr. Adimora is a professor of Medicine at UNC and also vice chair of the HIV Medicine Association, a national organization working on HIV policy issues. Like Dr. Vanderhorst, Dr. Adimora notes North Carolina’s low national health rankings as one reason for expanding Medicaid.

We rank 38th in the nation in terms of health outcomes, including mortality rates and other measures, like how many adults have diabetes. We’re 12th highest in the number of people diagnosed with AIDS, a condition now preventable if patients are diagnosed early and have access to care and treatment available through programs like Medicaid.

Dr. Adimora also describes her personal experience treating low income North Carolinians:

In my practice, I treat patients with infectious diseases, including those infected with HIV. I see firsthand the struggles many of them face because they cannot afford or do not qualify for health insurance. Too many don’t receive the care they need until they are seriously ill when treatment is less effective. Their lives are often needlessly shorter and hospital bills higher than if they had the regular access to care that Medicaid provides.

While North Carolina’s political leaders seem immune to moral arguments, Governor Kasich of Ohio, who has come out in support of Medicaid expansion, used his State of the State address to make the moral argument for expansion.  Governor Kasich said

I can’t look at the disabled, I can’t look at the poor, I can’t look at the mentally ill, I can’t look at the addicted and think we ought to ignore them. For those who live in the shadows of life, for those who are the least among us, I will not accept the fact that the most vulnerable in our state should be ignored. We can help them.

North Carolina’s leaders have offered no plan whatsoever for helping the half million North Carolinians who would gain coverage under Medicaid expansion. Until they can get past their anti-government, tea party fervor, it’s unlikely they will.

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