Expanding Medicaid in Montana much more than politics

I have been a registered nurse in Montana for 20 years and now serve the profession as the executive director of the Montana Nurses Association. I’d like to bring the perspective of registered nurses to the debate of expanding Medicaid coverage to 69,000 Montanans projected to qualify under the Affordable Care Act.

We were pleased to see that the Montana Medical Association (doctors) and the Montana Hospital Association recently announced their support for this expansion, and I’ll try not to repeat the arguments they presented. And although the doctors and the hospital administrators accurately presented an overview of the consequences of our current structure for providing healthcare to uninsured and Montanans in poverty, I’d like to bring these down to the real world terms that practicing nurses see daily in their jobs.

Emergency room use by individuals without insurance is not only costly for our health care system, but the health care consequences for non-insured Montanans can be devastating. Our members see firsthand on a daily basis the patients who enter emergency rooms suffering from ear aches, toothaches, sore throats, fevers and a host of other conditions. Many of these patients have waited too long to have their conditions diagnosed and treated, often because they or their children have no health insurance and they cannot afford to see a health care providers.

An untreated ear ache can result in diminished hearing and further complications, and untreated or delayed care can lead to further more complicated multiple issue presentations. In fact, many conditions can result in infecting other individuals, including kids, compounding the costs and medical outcomes for an expanded number of Montana families. Expanding Medicaid coverage to additional families will reduce both the monetary and patient outcome costs.

Montana is currently experiencing a shortage of primary health care providers especially our rural areas, which are areas of significant poverty. Recruiting physicians, nurses and other health care providers to these areas will require that they be paid for the services they render. Expanding Medicaid coverage to rural areas in poverty will assure that many of the health care services needed will be delivered by health care professionals who can afford to locate, work and live in these areas.

Expanding Medicaid coverage will also mean that more Montanans will have access to preventive care. Early diagnosis of the conditions leading to diabetes, heart attacks, strokes, obesity and many others can not only prevent the onset of such conditions but also results in lower overall health care costs. Experts on all sides of the Medicaid expansion debate agree that preventative care is a cost saver for everyone.

Expanding Medicaid will also mean that Montanans suspecting serious medical conditions will be more likely to seek medical help at earlier stages of their conditions. Those with diabetes may follow their condition more closely, avoiding future the complications that create indescribable suffering and major medical issues driven by this insidious disease. Catching and treating the most common cancers — prostate in men and breast cancer in women — saves lives, improves treatment outcomes, preserves quality of lives and costs far less than late diagnosis and treatment. The same is true with diagnosing and treating conditions such as autism with the cost savings occurring in both the areas of health care and education.

Health care professionals in every area of service know that prevention, early diagnosis and treatment are universally recognized as preserving quality of life and saving dollars. From dentists to eye doctors to physicians to chiropractors to naturopaths and beyond, every credible health care provider will tell you that regular checkups, healthy choices and early intervention results in the best outcomes for their patients.

In short, expanding Medicaid to the 69,000 Montanans currently without health insurance will improve the health of thousands of Montana families, prevent premature deaths of hundreds, create additional incentives to encourage health care professionals to live and work in rural Montana and save millions of dollars in health care costs and education in our state.

I represent the constituent members of the Montana Nurses Association, and I am a practicing nurse at my local hospital. I inform my patients regularly that I wouldn’t be doing my job if I avoided telling them the things they must change to improve their health.

Regarding the expansion of Medicaid, I would not be a good nurse by taking a “wait and see” approach to such an important healthcare decision for our Montana citizens. In health care, there can generally be an opposing argument as to why an intervention may not be the best decision for a patient. In caring for our citizens, this is the best decision for improved health and decreased cost in this complex health care system.

Rep. Pat Noonan, D-Ramsay, has introduced House Bill 458 to implement Medicaid expansion in Montana. We would encourage all Montanans to contact their legislators and urge support for this important legislation.

Lori Chovanak, MN, RN, is the executive director of the Montana Nurses Association.