Preserve Medicaid

Cuts could hobble vital services

Summer is a busy season for first responders—kids are out of school, people are out on hiking trails, ballfields, lakes and swimming pools.

While we haven’t yet seen the record heat to match the Southwest, high temperatures can be dangerous to everyone. As the director of MEMS, Arkansas’ largest ambulance system, I take very seriously our duty to be prepared for anything.

But regardless of the season, preparation is only a half-measure if you don’t have the resources to respond. As the debate over the future of American health care continues, I remain wary of the impact proposed cuts and restructuring of Medicaid will have on ambulance services. With so many of our citizens, particularly our youngest and oldest, receiving services through Medicaid, reductions in funding will hinder our ability to provide help and transportation to people who may need it most. Arkansas has the nation’s highest rate of children in small towns and rural areas who depend on Medicaid for health care.

We hear statistics about how many million Americans could lose their insurance if Medicaid cuts come to fruition. Just as important is realizing that even if you remain insured, your policy may no longer cover some services, including ambulance calls. Patients may discover after emergency treatment that not only did that treatment cost more than before, but that the payment for the ambulance ride is now their financial responsibility, as well.

Moreover, EMS providers have a moral and legal responsibility to respond to every call for help, regardless of the ability to pay.

Even with the current levels of reimbursement, EMS providers are struggling financially to recruit and retain the quality people needed to insure the health and safety of the people of Arkansas. The Arkansas Department of Health reports that 158 paramedics did not recertify by the cutoff date in March this year, and estimates that only 60 new paramedics will complete training by the end of December.

Medicaid cuts would not only hobble current services, they very certainly will stifle the innovation and ideas that can achieve real cost savings in health care. We must remain focused on the long-term picture to ensure that reforms have positive, lasting effects.

For example, MEMS and other EMS providers in the state have been developing a service similar to others around the country called Community Paramedicine. Paramedics will visit patients they may have helped before, using staff vehicles instead of ambulances. With some simple interactions, they can determine if immediate additional hospital care is needed or if steps can be taken to reduce the need for re-hospitalization and unnecessary 911 calls. Repeated admissions of the same patient can carry penalties for hospitals and is costly for insurance providers and patients.

Having the funds for preventive medicine in our hospitals and our communities costs far less today than emergency or long-term care tomorrow.

Arkansas has been a national leader in making the best use of federal funding in the years following the passage of the Affordable Care Act. Whatever comes next must protect Arkansans and the funding the medical community needs to care for them.

Even with a delay in the Senate’s vote, I encourage you to reach out to Sens. Tom Cotton and John Boozman. Let them know what has worked well in your life and your community when it comes to health care.

You will be affected by health-care reform, so make sure your voice is heard.

Summer is generally a time for relaxation and recreation. But this summer, there is much work to be done, and steps to take to ensure we can continue to provide services properly and affordably.