Editor’s Note: Wednesday’s RockinghamNow will look at the health of the county’s two rural hospitals and examine how they will survive financially in the absence of Medicaid expansion.
EDEN—Dr. William S. Luking has seen tragedy every week for 26 years — terminally ill patients, accident victims, and folks whose lives are cut short by abuse. But thoughts of one harrowing train wreck keep the veteran Reidsville physician up at night.
An engine is chugging down the tracks toward a damaged bridge and passengers are headed for certain death. Only the engineers will survive as they make a well-timed jump from the doomed cars.
“I look at this as a slow moving, 500,000-car-long train wreck,’’ Luking told participants during a Wednesday night vigil at Leaksville United Methodist Church to honor those in the state who died this year due to lack of access to health insurance.
This hell train is the metaphor Luking uses to describe the fate of an estimated half million imperiled North Carolinians who are without health care insurance due to the state legislature’s refusal over the past five years to expand Medicaid coverage.
Roughly 4,400 people in Rockingham County alone are seated in those ill-fated passenger cars, desperate for help to buy basics like insulin, blood pressure drugs, and life-saving services and procedures.
Despite that, state lawmakers recently voted again to reject federal dollars that would expand Medicaid eligibility and mean $19 million in savings from uncompensated care for hospitals, according to the North Carolina Rural Institute.
Luking’s metaphor puts the striped caps of the engineers and brakemen on district legislators Sen. Phil Berger, Rep. Kyle Hall and Rep. Jerry Carter.
They are “running the train,’’ pushing full bore toward disaster, holding fast to “flawed ideology’’ that keeps them refusing to make coverage available to the state’s working poor, Luking said.
“The bridge ahead is down, and the conductors of the train step off the train just in time,’’ said Luking, who serves more than 5,000 Rockingham County patients in his practice. “All these guys step off. And the train plunges into the gully, and they call it a day. They step off … right before it hits bottom.’’
Such politicians’ ideology holds that Medicaid is somehow a form of “socialized medicine’’ and is inherently bad, Luking said. And he called on legislators and citizens to remember that Social Security and Medicare were once labeled the same way before becoming central accepted safeguards for our society.
Berger, Hall and Carter, asked Thursday for comment by phone and by email, did not respond to questions about why they voted against Medicaid expansion and what health care options they recommend for those in their district who do not qualify for Medicaid.
The legislators were further asked if they use state employee health insurance policies offered to them at no charge as lawmakers. State legislators, who work roughly six months per year, are among the few part-time state employees who benefit from the same health care perks as full-time state employees, such as the governor.
None of the three Rockingham County representatives answered the inquiries or questions about the amounts of their co-pays for standard sick visits and prescription medications.
A spokesman for Hall said the legislator would be “driving across the state” and unable to respond before deadline.
Fellow Rockingham County physician Dr. Sandi Fields, a longtime Reidsville gastroenterologist, joined in the vigil to describe how her patients suffer without Medicaid.
“Every day, I see our families and our friends come into my office and say they can’t afford treatment or medicine. Every … single … day,’’ Fields said. “People are dying because they lack access,’’ Fields said of needed Medicaid expansion.
Legislators’ contention that the state cannot afford to expand Medicaid doesn’t add up, Fields said. By administering preventive care to avoid health disasters, she could save lives and millions of taxpayer dollars, she said.
For example, Fields explained that if a single individual can afford treatment for high blood pressure and diabetes through Medicaid, the patient can dodge kidney failure and the need for $90,000 dialysis care.
By failing to offer preventive care on the front end, “We are paying for it on the back end. We should not accept this,’’ Fields said. To legislators who say the state cannot afford Medicaid expansion, “I say, why not?’’
“We cannot stop until they (legislators) fix the health care dilemma in this state,’’ Fields said. “We must refuse to let them shirk from this responsibility.’’
Members of the clergy, city officials and concerned citizens joined for the small vigil, one of 20 similar events organized statewide by the N.C. Justice Center.
Luking shared anecdotes to illustrate the dire straits his Rockingham County patients face without Medicaid:
- An adult woman who earns minimum wage skipped preventive health care treatment and regular check ups for her asthma for many years. She recently visited Luking “faltering” with a worsened condition due to her inability to afford regular care, he said.
- A prideful uninsured patient, strapped for funds and suffering with chest pains, put off seeing Luking. The patient never made it to his office, Luking lamented. “I did see him the following week. At the funeral home.’’
- An elderly woman in the last year of her life, with no option for shelter but her dilapidated home, watched home health nurses withdraw after they “fell through the floor of her trailer,’’ Luking said.
- A middle-aged man who lost his job and insurance when Eden’s Miller/Coors plant closed, “disappeared” from regular doctor visits for his hypertension and diabetes because he could not afford care. The patient recently returned, but cannot afford essential medications.
Denying health care access is tantamount to violent crime, Luking said, growing emotional as he recounted his patients’ struggles.
“These people are working … they are already bustin’ it, but can’t begin to pay for the cost of health care,’’ he said, emphasizing the majority of those who need Medicaid are working people earning below a living wage.
The World Health Organization defines violence several ways including: “When an institution makes decisions that lead to substantial harm to groups of people,’’ Luking said, equating the state’s denial of Medicaid access.
“If I can find any definition of violence better than that, I don’t know what it is.”