Jan 10, 2020

HINEMAN: Breathing life into rural Kan. hospitals is critical

Posted Jan 10, 2020 11:55 AM

By DON HINEMAN
118th District State Representative

Two decades ago my wife Betsy experienced a sudden cardiac arrest.  Her heart had gone into a dangerous abnormal rhythm and had stopped pumping blood.  Fortunately, a team of EMTs arrived quickly to administer CPR and use a defibrillator to shock her heart back into normal rhythm.  She was taken to Lane County Hospital to stabilize her condition prior to being airlifted to Wichita for diagnosis and treatment.

Betsy is alive and doing well today because our rural healthcare system was there and functioned effectively in her time of need.  I will be forever grateful to all who assisted in her care that day, and to those pioneers who created and sustained the network of healthcare that saved her life.

I shudder to think what could have been had that network not been in place.  And that is a very real concern.  Eighty-five percent of Kansas hospitals are operating with negative operating margins today, forcing rural counties to subsidize hospital budgets with funds from local property taxes.  That creates the very real prospect that some of those hospitals may close their doors at some point, as has already happened in several Kansas communities.

During my work on the House Rural Revitalization Committee this past year, it became apparent how vitally important a local hospital is to its community.  That is obviously true to those who, like Betsy, receive care there.  But it is also true for the community itself.  It really becomes an economic development and sustainability issue.  The cornerstones of any community are its school system and its healthcare delivery system.  If either is missing or is viewed as inadequate, the community faces real challenges holding on to its existing population and businesses, and the prospect of recruiting new families or businesses becomes impossibly difficult.

One of the most important issues facing the legislature as we convene this week to start the 2020 Kansas legislative session, is a proposal to expand Medicaid to provide coverage to a larger segment of the population.  Thirty-seven states have already taken that step, and I believe it is now time for Kansas to follow their lead.  I have not come to this conclusion easily, for I understand that once any new governmental program is initiated it is likely to continue forever.  But our hospitals are struggling financially with too much uncompensated care on their accounts receivable ledger, and too many indigent uninsured patients accessing expensive ER care for non-ER symptoms because they have nowhere else to turn.

If Kansas expands Medicaid, roughly 150,00 of our fellow Kansans will receive healthcare coverage that is unaffordable to them today.  And the federal government will pay 90% of the cost, pumping hundreds of millions of dollars annually into the Kansas healthcare delivery system.  The economic activity that creates will essentially cover the 10% of the cost the state must pay, through greater sales, income and property tax revenues created by a more robust and thriving economy.

Who are these 150,000 Kansans who would become eligible for coverage?  They are the server at your local restaurant.  They are the maid who cleans your room on your next hotel stay.  They are the Kansans who are working one or more low-wage jobs to make ends meet and do not receive health insurance through their employer.  I acknowledge that it also includes some Kansans who are able-bodied but not working.  Are they satisfied with being unproductive members of society… happy to be living on the government dole?  While that may be true in some cases, the system envisioned for Kansas would encourage and assist the new Medicaid enrollees in finding work.  And states which have already expanded have found that a significant portion of the newly enrolled are exiting the program within a couple of years.  Their Medicaid coverage had relieved financial stress, improved their health, and reduced the dysfunction in their lives.  As a result, they were able to move up the economic ladder and drop out of Medicaid.  They became fully productive members of their state’s economy.  Kansas is currently at full employment, and Kansas businesses are constrained by a lack of an adequate workforce.  Expanding Medicaid could help provide additional workers for our economy at a time we desperately need them.

I recognize that expanding Medicaid will not solve all the problems of Kansas hospitals.  Healthcare is evolving, and the healthcare system of the past is not appropriate for the future.  But I have visited with many hospital administrators and am encouraged that they understand this reality and are working to reinvent how they deliver healthcare.  Expanding Medicaid can throw them a lifeline, creating an opportunity for them to not only survive but emerge stronger and better equipped to meet the needs of Kansans in the 21st century.

I am honored to represent the residents of the 118th District in Topeka.  Please contact me with your concerns as we dive into the work of the 2020 legislative session.

Representative Don Hineman, [email protected]