The wrong way to reform health care

A proposal by the Trump administration to impose lifetime limits on adults' access to Medicaid coverage is a recipe for disaster.

Medicaid, which is a joint state and federal program, provides health care coverage to low-income and disabled people. Recipients are the working poor, children, the elderly and people with disabilities. They have no other option for adequate care.

Oregon's Medicaid program, which is called the Oregon Health Plan, covers about 1 million people, 40 percent of whom are children. (Eligibility for Medicaid is highest among children and pregnant women in Oregon.)

An additional 17 percent of the people receiving Medicaid are elderly and disabled. They account for a disproportionate share of Medicaid costs — 41 percent, according to a study by the Henry J. Kaiser Foundation.

The vast majority of people receiving Medicaid in Oregon are the working poor. Eighty-one percent of the people on the Oregon Health Plan are in families with at least one member who is working. These families just don't have access to health care through an employer and can't afford to buy it on the private market.

Cutting off Medicaid at an arbitrary limit would result in a sentence of suffering, and potentially a shortened life span, for people whose only crime is to be ill and poor.

Some with serious ailments or injuries would no doubt show up in emergency rooms in search of relief, as was more common in the past, creating the double negative of increasing health care costs for everyone while depriving these patients of the comprehensive care they need to become, or stay, healthy.

Setting aside the sheer inhumanity of this, it makes no economic sense.

People who have no health care coverage and so resort to hospital emergency rooms as their only recourse impose higher costs upon hospitals. By extension, other patients see increased charges for the services they receive, and insurance premiums go up as a result.

Rising health care costs are a problem — locally, statewide and nationally. There have been increasing calls for a complete overhaul of the U.S. health care system to contain costs and improve service, including growing support for some sort of single-payer system, which has problems of its own.

There also have been some problems that need to be cleaned up. For example, Oregon found last year that tens of thousands of people who were not eligible for Medicaid, or were no longer eligible, were receiving it. This needs to be dealt with, quickly.

But rationing health care to the most vulnerable Americans — primarily poor people with chronic disabilities and illnesses that require expensive care — is not the way to reform health care. It raises the specter of citizens of one of the richest countries in the world growing sicker, or suffering from worsening disabilities, even dying, because their government says they have reached the limit of their health care benefits.

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