- Rob Ledbetter, a Columbia, Tennessee native, is a third-year medical student in Winston-Salem, North Carolina.
I stared through the glass door of a negative pressure room at the hospital. It was covered in red laminated signs bearing the phrase, “WARNING: ADVANCED DROPLET PRECAUTIONS,” and surrounded by face shields that were hopefully sanitized before being abandoned.
A litany of various life-sustaining tubes obscured the patient’s face, but it was no mystery what he had–what every patient on this floor had.
The battle doesn’t end when the fever breaks and the tubes are pulled from your throat. Some Americans are charged a million dollars to survive. Another was more concerned about who will pay for his ventilator rather than saying goodbye to his wife. Lung transplants are even more expensive.
During the worst disease outbreak in a century, tens of millions of Americans who relied on their employer for health insurance were left without options as they filed for unemployment benefits in record numbers.
In response to this public need, Oklahoma became the first state of the COVID-19 era to pass Medicaid expansion, prompting other states to reexamine their own health care systems. Currently, Tennessee is one of 13 states still yet to endorse Medicaid expansion.
Because of this decision, Tennessee has lost an estimated $7 billion in federal health care funding and nearly 700,000 Tennesseans endure without health insurance. But most tragically, each year many die because they do not have adequate access to health care.
Tennessee block grant plan is ineffective
Even though states with Medicaid expansion witness a sharp decline in their annual death rate, Tennessee Gov. Bill Lee has pushed for an ineffective alternative with opposite results — limiting Medicaid through block grants. Block grants work by setting a firm cap on how much money can go to Medicaid, in the same way a family might set a firm cap on a grocery budget regardless of how many children are still hungry.
Block grant funding does not adequately provide Tennesseans with the health care that we need.
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Block grants are a way for Lee to ignore the current public health crisis and pretend our health care needs do not exist.
Limiting health care access and refusing to invest in our people lead to debilitating chronic illnesses that are not only damaging for the people they affect but are expensive–comprising one-third of American health care spending.
To be clear, we are spending more money to have worse health care.
There is no excuse for these deaths in the wealthiest nation in history.
There is no excuse for allowing Americans to disproportionately develop debilitating chronic illnesses because preventative medicine is not a priority.
There is no excuse for Tennessee to fall behind our neighbors who have already passed Medicaid expansion.
U.S. health care is needlessly expensive
In the words of Harvard Medical School professor Steffie Woolhandler, “Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and [thousands] pay with their lives.”
During the period of the greatest loss of life since World War II, we must take time to reexamine our former status quo and decide which parts are worth keeping, and what needs to change. We must ask ourselves: what have we learned?
Lee must provide a resolute endorsement and enactment of Medicaid expansion, rather than increase the number of Tennesseans who will suffer and die without health care.
Rob Ledbetter, a Columbia, Tennessee native, is a third-year medical student in Winston-Salem, North Carolina. He is a graduate of of the University of Tennessee and Columbia Central High School.