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Sunday, May 12, 2013

Medicaid expansion spreads coverage, reduces costs

As the president of the New Hampshire Nurses’ Association, I have had many conversations with nurses about the delivery of high quality health care. I have yet to have a conversation that does not conclude with someone stating the obvious – we have to figure out how to bring everyone under the tent so we can get serious about prevention.

Every nurse knows that prevention and personal responsibility are the keys to a healthy life and affordable health care. So why is it so hard? ...

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As the president of the New Hampshire Nurses’ Association, I have had many conversations with nurses about the delivery of high quality health care. I have yet to have a conversation that does not conclude with someone stating the obvious – we have to figure out how to bring everyone under the tent so we can get serious about prevention.

Every nurse knows that prevention and personal responsibility are the keys to a healthy life and affordable health care. So why is it so hard?

One Fund Boston collected over $25 million in one week to help cover the health care costs associated with the serious injuries suffered by dozens of innocent victims at the Boston Marathon bombings. Driven by the horror and our feelings of helplessness, we opened our hearts and our wallets. Good for us.

On a very basic level, we knew that helping victims get the treatment they needed was the best help we could give. Ensuring they get high quality care and can return home to their jobs and families gives them – and us – a way to heal. Fortunately, most health problems are neither as unexpected nor as horrifying as injuries from a terrorist attack.

Most health problems start small and our ability to get prompt, affordable treatment will decide whether that health problem is cured, controlled, or drives us into an emergency room in crisis in the middle of the night.

We, as a state, as a nation, face a real challenge in getting more people the care they need before they reach a crisis – bringing them under the tent.

New Hampshire has an opportunity, right now, to advance this laudable goal. Our House and Senate members will soon decide whether to accept federal funds allocated to our state to extend health coverage to thousands of people currently without health insurance.

For the next three years, the federal government is offering to pay 100 percent of the costs to insure, via Medicaid, more low income workers and their families.

Estimates suggest this would help as many as 58,000 Granite Staters by 2020. Starting in 2017, New Hampshire would gradually contribute toward the cost but never more than 10 percent under federal law.

Most of the people who would be helped by the expanded coverage are employed and hard-working, but they lack the education or opportunity to secure a position that offers health benefits. To leave them outside the tent means they have no easy access to preventive care. The irony about our current system is that these folks will get treatment in a crisis. New Hampshire hospitals support a robust system of financial assistance, funded largely by the premiums charged to those of us who are privileged enough to have health insurance.

Unfortunately, paying to care for someone with colon cancer is hundreds of times more expensive than paying for a colonoscopy that allows for early treatment to prevent the disease.

Accidents and sudden health emergencies – even acts of violence – will unfortunately remain a risk for all of us and everyone deserves high quality care when disaster strikes. But we can also do more to contribute to our community’s well-being – and reduce costs – by encouraging wellness and preventing disease.

The first step is to bring everyone under the tent. Taking the federal dollars to extend Medicaid to more people benefits us all and moves us closer to a health care system focused on prevention rather than crisis. That’s why the New Hampshire Nurses’ Association supports the expansion of Medicaid and urges our lawmakers to do likewise.

Judith Joy is a registered nurse and president of the New Hampshire Nurses’ Association.