I have read that certain prominent individuals oppose the proposal to use Trust Fund money for the next three years to basically save the Medicaid program. These folks are not giving Gov. Bentley credit for all of the reductions in spending his administration has already accomplished. This administration is well on its way to appropriately balancing the budget, however you cannot correct years of mismanagement in one year, especially with this economy. You cannot run a state on taxes based mostly on income when income is down. No one seems interested in changing our property tax system that would give a more stable tax basis. This Medicaid budget problem is not new. Even before Gov. Bentley was elected, everyone knew that 2013 was going to be a bad year for Medicaid yet nothing was done about it.

Opponents of using Trust Fund monies to help stabilize the budget say critical services must be cut in the name of fiscal responsibility. If those critical services happen to involve dialysis, then you are condemning those individuals to death simply because you will not use existing state funds to get through some bad times. Gov. Bentley’s administration is already well into a program to improve Medicaid but it can’t be accomplished overnight. We need these three years that a “yes” vote on Sept. 18th will give Alabama. I can think of no more emergent situation than the one at present. If Medicaid fails then we will lose most all of our rural hospitals and 60 percent of our nursing homes. Our two major children’s hospitals in Mobile and Birmingham will suffer severely. Physicians will leave the state and everyone will see their services cut. You can do away with the Medicaid program, but you cannot do away with the Medicaid patient. Society will still have to take care of these folks and once these hospitals and nursing homes close, they can’t easily be re-opened if and when funding is restored.

If this constitutional amendment is not approved, the consequences will be disastrous. When a political ideology is so rigid that it cannot be bent even slightly for the greater good, then we have a problem. The benefits from the borrowing of this money will do tremendous good for our state, and Gov. Bentley has promised that it will be paid back, as have the leaders in the House and Senate. For those of you who don’t know, after we borrow this money from the trust fund for three years the fund will still have more than $300 million more than it does today because of other money going into it. Our state Medicaid budget is a little over $600 million a year and this generates more than $6 billion annually to Alabama’s economy when combined with federal matching dollars. So folks who are voting “no” are willing for us to drive our health care system into the ground and lose $6 billion to our economy just because they don’t want to borrow money out of our own savings account for this critical time in Alabama’s history.

I have been working in organized medicine for more than 25 years and I feel this is the most important vote we have had in our state with regards to health care in my lifetime. I am strongly in support of being fiscally responsible and I also believe in individual responsibility and consequences for your actions. I do not believe in “Obamacare” or the statement that health care is an inalienable right; however, I do strongly believe that as a God-fearing nation and a nation that has been blessed more than we deserve, that it is our responsibility to see that everyone is given the opportunity to have adequate health care. Our Medicaid and Medicare programs are the basis of the health care system in Alabama and are integral to our mission to take care of everyone. We must vote “YES” on Sept. 18th and not lose these important health care dollars just because of a rigid political ideology.

 

W. Jeff Terry, M.D.

Past President, Medical Association of the State of Alabama

Mobile