Medicaid expansion would save lives

By Joseph Kanter, M.D., and Elmore Rigamer, M.D.
The Times-Picayune (New Orleans), Letters, April 2, 2014

Re "Protesters call for Reversal of Medicaid," Sunday, (March 30) A13: We know that people who do not have health insurance have a hard time getting the care they need. Care received in emergency rooms or free clinics cannot address the complex medical problems that come with years of being uninsured.

People who do not have regular access to health care are sicker when they get sick and have a short­ened life expectancy.

In Louisiana, Medicaid expansion would have covered 272,000 people and saved 249 to 542 lives annually, according to the Census Bureau and Dickman, Woolhandler et al. in Health Affairs 2014.

Drs. Kanter and Rigamer reside in New Orleans.

A plea for Medicaid coverage for our suffering citizens

By Jennifer Avegno, M.D., Joseph Kanter, M.D., and Elmore Rigamer, M.D.
The Times-Picayune (New Orleans), March 3, 2014

Louisiana has one of the high­est rates of diabetes and cardio­vascular diseases in the country. Recent state Medicaid changes are leaving our most vulnerable patients without access to physi­cians, health services and essen­tial medications. The changes disrupt the relationships doctors have with patients and do not make economic sense. As physi­cians in the Interim LSU Hospi­tal Emergency Department and a local community clinic, we have seen patients return time and again to the ER because they have been unable to fill their essential prescriptions or access their physicians.

The people most affected by these changes often live on the economic margins of our communities. Frequently, their chronic diseases get worse at the end of the month when they run out of food and cannot eat properly. Few have jobs that have sick leave and a day in the ER is lost wages. The monthly costs for one of these patients' medication pales in comparison to the $20,000 average cost for a four-day hospital stay. Costs to the health system are multiples of what they would be if patients were being treated by routine outpatient visits and proper medications.

We believe the Legislature should prevail upon Gov. Bobby Jindal to reconsider his decision not to expand Medicaid and ask him to reverse the changes made to the program Jan. 1, 2014. We ask that everyone at or below the federal poverty level who has diabetes, hypertension and heart or respiratory disease receive medications to control these diseases.

This will improve the qual­ity of their lives and minimize the costs of treating the future preventable complications. The state and the city of New Orleans did a remarkable job of opening community health clinics in New Orleans after Katrina. What sense does it make for some of our patients to come to the clinics, receive high quality care, and leave without the means to treat their medical problems?

Jennifer Avegno, M.D., is clinical assistant professor of emergency medicine Interim LSU Hospital New Orleans; Joseph Kanter, M.D., is chief resident, emergency department, Interim LSU Hospital; and Elmore Rigamer, M.D., is medical director of Catholic Charities Archdiocese of New Orleans.