Medical providers need to take leadership role in U.S. health reform debate

They need to be loud and strong on plan to repeal and replace Obamacare.

April 25, 2017 at 10:14PM
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iStockphoto.com (The Minnesota Star Tribune)

Doctors and nurses regularly rank among the nation's most respected professions. That's why they need to become the loudest voices in the room as Republican efforts to replace former President Obama's Affordable Care Act stagger forward.

In March, the Republican replacement plan — dubbed the American Health Care Act (AHCA) — failed to gather enough support within the GOP-controlled House to merit a floor vote. But discussions are still underway to find a compromise between the House Freedom Caucus, which thought the AHCA was still too generous to those who need help buying coverage, and more moderate Republicans, who thought the bill would throw too many people off insurance rolls.

As negotiations continue after the congressional spring break, updates regrettably lean toward meeting Freedom Caucus demands. A less well-understood proposal from the original plan also remains under consideration: $880 billion worth of cuts to Medicaid over 10 years. Medicaid is the state- and federally-funded safety net program that pays for the bulk of long-term care for the elderly and disabled, as well as medical coverage for the poor.

The Editorial Board has long sounded the alarm about the AHCA's proposed federal funding cuts to Medicaid, warning that the cuts for nursing home care would occur just as the aging wave of baby boomers needs it. But a timely, praiseworthy push from the Children's Hospital Association points out that another critical group — kids — stands to lose if the Medicaid cuts go through.

Over the weekend, a letter signed by the chief executives of 65 pediatric specialty hospitals — including two from Minnesota medical centers — appeared in a full-page advertisement in the New York Times. The missive is short but passionate. "The health care debates for the past decades have focused on adults ... . The fact that 30 million children receive their health care through Medicaid is hardly ever discussed,'' the letter stated. "Where are kids in these discussions? Do Congress and the White House see safeguarding children's health care as a national priority?"

Nearly half the nation's children are served by Medicaid, said Mark Wietecha, president and CEO of the Children's Hospital Association. In contrast, about one in six adults is on Medicaid. What that means, Wietecha argued in a Monday interview, is that the Medicaid cuts are "really a disproportionate cut to children and we are asking people to step up and talk about that, because the answer is urgent. Is this really our national policy? To cut benefits to children to save money?"

The two Minnesota CEO's who signed the letter are Dr. Robert Bonar of Children's Minnesota, and Barbara Walcyzk Joers of Gillette Children's Specialty Healthcare Minnesota. Their leadership is to be emulated.

Health care is complex, emotional and, unfortunately, the subject of much political gamesmanship. The trusted voices of the nation's medical providers are needed more than ever to help current and future patients cut through the rhetoric.

Few of the nation's leading medical organizations support the Republican replacement plan. And while they may be working behind the scenes lobbying Congress and keeping members up to date, it's time for them to amplify their arguments and make them more public.

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