Article on Medicaid spending overlooked physicians’ duty to provide care | Letter to the editor

I am writing in response to the Aug. 6 Oregon Journalism Project article, also published in Lookout Eugene-Springfield, about state spending on Medicaid. I am an emergency physician in Lane County. I am obligated under federal law to treat everyone who checks in, regardless of ability to pay. I think the article missed the point.

Roughly 71% of Medicaid/Oregon Health Plan recipients are working. Over 40% are children. Without adequate coverage, families risk financial hardship or bankruptcy for seeking emergency care.

The expansion of the Oregon Health Plan has been paramount in helping to dismantle inequity related to healthcare. Those inequities will become greater with the implementation of H.R. 1 unless Oregon is proactive in addressing them.

Most of my patients rely on chronic medications and preventive care. Imagine what will happen when people can no longer afford a doctor’s visit or medication. They may ignore symptoms because they fear the cost, waiting until the problem becomes unbearable, severe and life threatening. I’ve seen the results of delayed care. Chest pain becomes a life-threatening heart attack. Abdominal pain progresses to emergency surgery for a perforated bowel. A simple foot wound results in an amputation.

This is the looming problem that will affect children and adults if coverage is reduced. Further, these emergent cases are often treated in the emergency department, where federal laws require treatment for all, at a total cost to society that often exceeds what we would incur by providing regular, routine care.

In Oregon, everyone should have access to health coverage. I believe access to healthcare is a basic right, and Medicaid and the Oregon Health Plan are vital to achieving this goal. The federal H.R. 1 Medicaid cuts will challenge our ability, as Oregonians, to ensure that everyone has access to this fundamental right. We must recognize the real-world consequences of these cuts and act proactively to protect the health of our families, neighbors and communities.

Bianca Jacobs, M.D.
Eugene