Editorial: Who should pay for health care?

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If you had a medical need arise and didn’t have the money to pay for it, what would you hope would happen?

This is an everyday question for many in our state, local community, church and perhaps our family. It might even be our own daily concern.

Neither public nor private responses have reduced the cost of health care or eliminated the need for financial assistance to pay for it. We are well-aware of this, especially when the bills come due.

The cost of health care has not escaped the attention of the Texas Legislature. After brief debate on April 22, legislators rejected a budget amendment that had the potential to provide health care coverage for uninsured Texans.

House Bill 3871—which would create a plan called Live Well Texas—was referred to the Health and Human Services Commission on March 24 and is still under consideration. The bill has bipartisan support for its attempt to address the need for greater access to health care, while also incentivizing against abuse of the program and working to increase physician reimbursements.

The budget amendment and proposed plan have at least one thing in common. They entail the expansion of Medicaid in Texas—a line in the sand since at least the passage of the Affordable Care Act in 2010.

On one side of the line are those calling for expanding Medicaid; on the other side are those opposing Medicaid expansion at every turn. The problem is, we’re all in the same sand. It doesn’t matter who cuts the check. One way or the other, we’re all going to pay for it.

Our health care is in a pickle, and we need to bring our best minds and efforts to the quandary, because it affects us all.

Where we are

According to the Texas Comptroller’s office, Texas has “the highest number and the highest percentage of uninsured residents in the nation.” Prior to the pandemic, 18.4 percent of Texans were uninsured—the majority being people of color—and that number increased during 2020. The comptroller does not see this as a point of pride.

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Some uninsured Texans earn too much income to qualify for Medicaid “under Texas eligibility rules” and don’t earn enough to purchase health insurance. Those falling into this gap are paying taxes, part of which fund federal programs like Medicaid, and yet are not eligible to receive any of what they pay in to the program.

Uninsured people are less likely to seek medical care, simply because they cannot afford it. One result is conditions needing medical attention go undiagnosed or untreated, worsen and result in higher costs—not to mention increased health concerns.

Insured Texans aren’t catching much of a break either, though they have more health care options than uninsured Texans. Premiums continue to rise, the burden of which is carried by employers and employees alike. At the same time, benefits are becoming less generous, adding higher out-of-pocket expenses to higher premiums.

Physicians and providers also are pinched. Educational and employment costs have risen almost exponentially. At the same time, reimbursement rates from private insurers, while considerably better than paltry reimbursements from Medicare and Medicaid, still don’t cover provider expenses entirely.

To keep their practices open, some providers have opted out of private insurance and federal programs altogether, and opted in to “concierge medicine.” And it’s not because these providers don’t care about people. They care deeply, so much they want to be able to stay in practice.

Our health care is in a pickle, and we’re all paying for it. How do we get out of it? If I knew, I wouldn’t be writing this editorial.

Where we’ve been

One thing I do know: Christians consistently have risen to health care challenges throughout history. They led the way in caring for victims of more than one plague, and they have been known for serving many societies’ castoffs and untouchables—the “least of these.”

Christians have engaged in medical missions around the globe. They have provided medical and dental clinics in the colonias surrounding Juarez, Mexico; a hospital on Ailigandí, a tiny island off the northern coast of Panama; and medical care throughout Africa, the Middle East, India and Southeast Asia.

During the last 200 years, various Christians established hospitals throughout the United States, some of which grew into entire health care systems. In Texas alone, Baptists, Presbyterians, Methodists and Catholics stand out in city skylines all over the state.

More recently, churches have helped eliminate millions of dollars in medical debt for people they may never meet.

Christians may know the need for and the cost of health care better than most. They also may know better than most how to provide it, no matter the cost.

Where we must go

And now, Christians—Baptists among them—need to bring our best minds and best efforts to the pickle our health care is in. In Jesus, we have our “why” and our “way.”

Jesus not only commands us to love one another (John 13:34), he assures us we will do greater things than he did (John 14:12). He didn’t say it would be easy; he did say it would cost us.

If you had a medical need arise and didn’t have the money to pay for it, what would you hope would happen? You likely would hope for help.

Should that help come through government programs, private insurance or some other means? That’s the question being debated by lawmakers in Austin this month.

Whatever they decide, make no mistake: We’re all going to pay for it.

Eric Black is the executive director, publisher and editor of the Baptist Standard. He can be reached at [email protected] or on Twitter at @EricBlackBSP.

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