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Op-ed: Medicaid expansion proper role of government

Published January 4, 2014 1:01 am

This is an archived article that was published on sltrib.com in 2014, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

State Sen. Allen Christensen, R-North Ogden, wrote in a Tribune commentary just before Christmas that he is worried about the current rate of federal government spending ("Medicaid expansion is just forced charity," Opinion, Dec. 21).

He suggested that Gov. Gary Herbert should avoid expanding Medicaid in Utah because he sees it as forced charity that will unnecessarily add to government expense.

However, not expanding Medicaid would be a short-sighted solution.

Sen. Christensen's argument tries to compare charitable giving at Christmastime with the provision of long-term health care for vulnerable populations. The two are not even remotely similar.

As the senator notes, Utahns give generously to toy drives and food pantries around the holidays. But Christmas donations will not suffice to provide ongoing medical treatment to the 123,586 Utahans who would benefit from a full Medicaid expansion.

Utah should expand Medicaid because government must play its part in matters that affect the public health of the state. If people in this state are unable to meet their basic needs such as health care, government is obligated to step in and do its part.

This does not mean government is solely responsible, but it must do what is in its power to promote the common good. In Utah today, that means expanding Medicaid to ensure that thousands of Utahns are able to receive basic medical care, including preventive treatment.

As the charity-care arm of the Medicaid Expansion Options Community Workgroup discovered, there is no feasible way for charities to provide adequate medical care for all of the Utahns who are unable to afford private insurance and do not currently qualify for Medicaid.

While charity care might cover sporadic visits, the health of all Utahns is better served by providing preventive as well as crisis treatment.

When an uninsured individual contracts a communicable disease, the uninsured is not the only person at risk. When an uninsured individual seeks care at an emergency room, the uninsured is not the only person whose medical costs are impacted. Uninsured individuals have broad impacts on all Utahns. The state has the ability to lessen those impacts by expanding Medicaid to cover uninsured Utahns who have no other options.

I agree with Sen. Christensen that each individual must take responsibility for his or her own welfare. Unfortunately, there are times in people's lives when they are unable to provide for all of their basic needs without assistance.

Charities may cover some of the needs, but the state is the only organization in a position to provide affordable health care options to ensure treatable conditions, such as diabetes or heart problems, do not become catastrophic, and exponentially more expensive, problems.

Granted, some individuals will abuse the safety net system, just as some abuse the free market system and political power. Government has a role to play in curbing such abuses as well. But first and foremost, it must do what is in its power to make accessible to each person what is needed to live a truly human life: food, clothing, health care, education, work.

Medicaid expansion is not forced charity. It is an opportunity for government to fill in a gap in health care coverage where thousands of individuals currently fall. Providing health care coverage will help Utah citizens avoid more serious complications from otherwise treatable diseases, enabling them to become more productive citizens.

The federal government is not demanding that Utah give toys to children, a function charities perform well. It is providing an opportunity for the state to protect the public health — a role that state government is meant to fulfill.

Jean Hill is government liaison for the Catholic Diocese of Salt Lake City.