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The charity fairy

Published March 13, 2013 1:01 am

Charity care won't solve the problem
This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

For years, those opposed to any real overhaul of the American health care system have liked to say that anyone can get free health care at their nearest emergency room. It was a lie then, and it's a lie now.

But because that fairy tale has lost much of its effectiveness, some dead-ender Obamacare opponents have come up with another whopper: Charity care can do the job better than Medicaid.

That argument carried the day Monday as the Utah House approved HB391, the bill that would ban Utah's participation in the expanded Medicaid program offered, and mostly paid for, by the Affordable Care Act.

It was troubling enough to hear Rep. Michael Kennedy raise the groundless argument that 130,000 Utahns who now lack health insurance — who would be added to the Medicaid rolls if Gov. Gary Herbert accepts the federal offer — could be served just as well by hordes of doctors suddenly agreeing to see patients for free.

It was more troubling to realize that he is also Dr. Michael Kennedy, an Orem-based physician, as his argument can only be based on a total misunderstanding of what real 21st century health care entails. And why it costs so much.

Recruiting more doctors to see more patients pro bono would be a good thing. But unless Kennedy could also scrounge up free vaccines, free antibiotics, free chemotherapy, free MRI machines, and get nurses, dietitians, lab techs, cooks and janitors to similarly donate significant amounts of professional time, his dream is totally out of touch with reality. So much so as to actually be deadly to low-income people.

Like the go-to-the-ER-for-health-care deception, the charity-care argument fails because it could never offer the efficient continuum of care that comes with real private health insurance, with Medicare and, properly done, with Medicaid.

Having a volunteer doctor peer down your throat, stitch up your wound or set your broken leg would indeed be a boon to many. But that's not health care. That's trauma care.

Real health care often involves long-term treatment, preferably through a clinic that monitors each patient's health over time. That kind of health care, not hit-and-miss ER or charity care, is the key to longer and healthier lives. And it is the only chance we have of bending down the unsustainable cost curve that, as HB391 supporters rightly argue, threatens to bankrupt us all.

Utah should expand Medicaid, and use it as a tool to really get a handle on costs. The idea that those costs can, instead, be magically wiped away by a few fairy god-doctors should not be entertained for another moment.