Big changes are afoot in North Carolina’s health care industry. Soon, the over 2 million recipients of Medicaid will be asked to sign up for new plans which will, if all goes to plan, improve their health outlook while decreasing costs. Medicaid transformation, as this change is called, was signed into law earlier this month, and recipients will start shifting over to the new system within a year.
Gov. Roy Cooper initially vetoed this measure last year despite wide bipartisan support because he wanted the bill to include Medicaid expansion, an optional provision of the Affordable Care Act that would enable more North Carolinians to enroll in the program.
While the passage of Medicaid transformation is long overdue, it will not solve systemic issues in our health care system on its own. At the very least, our state deserves Medicaid expansion, but more preferably, we would have a comprehensive public health care system that will more cheaply and effectively address our state’s needs. It’s more clear than ever during this pandemic that protecting the health of front-line, low-wage workers is key to protecting everyone’s health, and a crucial step in that effort is creating a universal health care system.
It’s easy to see why transformation is popular: It promises to reduce costs and improve people’s health. It does this by changing the way health care is paid for. Rather than reimbursing hospitals directly for procedures — thereby effectively encouraging them to conduct large batteries of tests without regard for the cost — the new system gives a managed care organization a lump sum of money to fund a person’s health expenses for a year, meaning that the less that person needs a hospital, the more money the company makes, a clear win-win situation.
However, health care costs are high for a wide array of reasons. One of those, the fact that people at lower income levels are disproportionately sicker than middle and upper class people, is partially attributed to a lack of ability to afford needed medications, and so it could be alleviated by expanding Medicaid.
It should be noted that this disparity also comes from a difference in environmental health impacts, such as the construction of large infrastructure projects that can lead to water and air pollution, so even Medicaid expansion isn’t a total fix.
That said, expanding Medicaid should be an easy policy to pass. It’s mostly funded by the federal government but it could lower total health care costs within North Carolina, with the clear benefit of ensuring more residents have access to life-saving medications, such as a certain eagerly-anticipated vaccine.
This pandemic will not end until almost everyone is vaccinated, regardless of their ability to pay. If legislators have so far refused to spend money to protect public health, who’s to say they’ll change their tune for this pandemic, or the next one? Fortunately, with the vaccine not expected until next year, we have an election coming up that could be critical in ensuring that both the federal and state governments respond to public health crises with the speed and seriousness that they deserve.
It likely will be a high priority for all officials to vaccinate the public against the novel coronavirus, but it shouldn’t take a pandemic to realize that everyone should have health care. Inconsistent access to medicine has been hurting the state for years already. Hopefully the lessons learned from this year will spur our leaders to take these matters more seriously, and finally create a comprehensive health care system to solve our comprehensive health problems.
