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Paul Ryan, Medicaid, And Health Needs From Gun Violence

July 9, 2017

Once again House Speaker Paul Ryan was talking to reporters about his desire to see that all Americans have “access to health care”.  And last week, like every other time he has waxed on his reform ideas for our nation’s heath care system, it leaves many realizing that “access” amounts to nothing more than having the freedom to be offered decent health insurance but also being too poor to buy it.

I have often thought about what Ryan proposes for health care alongside the growing everyday type headlines of gun violence in our nation.  With more than 30,000 people admitted to hospitals annually for firearm injuries, and a huge segment of them receiving Medicaid, there seems to be a vacuum of dialogue and common sense when it comes to our national reform efforts presently underway in congress.

One of the problems we face in this nation is the lack of data about gun violence since the government does not maintain a cumulative tally of how many gunshot victims receive health insurance through Medicaid.  However, a Stanford study found that 30 percent of gunshot patients nationwide were covered by Medicaid between 2006 and the year the Medicaid expansion kicked off, in 2014.   That is a sizable number with a costly bottom line when it comes to these types of injuries; often with long-term health consequences.

Plainly put, after reading the conclusion from the Congressional Budget Office, the latest healthcare proposal would shift the economic burden of treating gunshot victims to taxpayers, consumers and victims.  An estimated 22 million people will lose their insurance under the Republican healthcare plan being debated.  Just accounting for the costs of initial hospital visits for gunshot wounds the bill tops $700 million a year.  Add in the proposed cutbacks in the growth of Medicaid at the same time gun violence remains out of control, and the seriousness of what this nation faces is most clear to see. That is simply not a sustainable or rational approach to our health care problems.

I understand that Ryan has a powerfully difficult job as speaker to a caucus that is more rambunctious than rational.  But he must not stray too afar from the moral calling that those who govern must always employ in their jobs.  There is no way that anyone can walk the halls of emergency rooms in this country, ride with police officers, or even just pick up daily newspapers and not be aware of gun violence and the medical costs of such news.  Those costs from gun violence may not get reported in the papers daily but Ryan in his quest for health care reform needs to be mindful of it every step of the way.  And equally important he needs to have a national conversation about it.

In 2015 the Wisconsin Center for Investigative Journalism reported a most impressive must-read about gun violence which included the perspective of how health care needs are very much connected to the larger issue.

Last year, paramedics from the Milwaukee Fire Department provided services to 297 shooting victims. The average cost was $1,300 per patient, or roughly $386,100.

Statewide, there were 349 hospitalizations and 742 emergency department visits because of firearm-related injuries in 2014, according to Department of Health Services data.

About half of emergency visits and 60 percent of hospitalizations are covered by Medicaid or Medicare, which are public insurance programs. The total amount public insurance programs paid for gun-related injuries in 2014 was about $6 million after negotiations between health care providers and the state and physician fees are factored in.

The Wisconsin Hospital Association, which provided information to the Wisconsin Center for Investigative Journalism used to reach this estimate, cautioned that it is “very rough.”

2 Comments leave one →
  1. July 9, 2017 9:18 PM

    You referred to Paul Ryan and “moral calling” in the same sentence. I’d call that a stretch.

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