Tennessee Needs To Expand Medicaid

Wednesday, June 25, 2014

I am a disabled woman who practiced primary care medicine in Chattanooga for 20 years. I was on staff at Erlanger Medical Center and saw the crucial part it played in community health, caring for the uninsured and for Medicaid patients, as well as people like me who loved the quality of the teaching hospital. I chose to have my daughter there, and they handled her special birth problems in the neonatal intensive care unit. 

Several years of my medical practice were spent as a staff physician at the community health centers which operated in association with Erlanger Medical Center. Again, I was able to care for people who had Medicaid to cover problems that otherwise wouldn't have been diagnosed or treated. Many patients who were uninsured and working couldn't even afford to use the community health centers, and couldn't get onto the Medicaid roles because of limited funds. 

In caring for the poor of my community I saw the results of lack of insurance. People who can't get health screenings and preventive care suffer from the complications of diseases before they reach the health care system. For instance, it is common to diagnose high blood pressure during a screening exam in someone with insurance. That person receives cheap treatment and advice as they continue work. Without insurance, he might come into the health system much later with a severe stroke that leaves him disabled. A woman with early diabetes and insurance could be diagnosed on a screening test during a physical exam and given lifestyle advice and whatever treatment was necessary. Without insurance, that same person might present much later with diabetic kidney damage and blood vessel disease leading to a heart attack. 

Insured people stay healthy and working, and save us money. 

The Affordable Care Act is making it possible for millions to have good quality health insurance they can afford, but many working poor are being left out. In Tennessee the numbers are hundreds of thousands - poor and working poor with no coverage because Governor Haslam and Representative Fleischmann refuse to expand Medicaid. How can they refuse a program that costs our state nothing and that will help families receive the care that we all need? It is time to put people over politics.

Essie Bruell
Chattanooga

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