Dear Lieutenant Gov. Jeff Colyer,
It seems that you may be the face of Kansas soon. Gov. Sam Brownback might be leaving to become ambassador-at-large for international religious freedom, to the jubilation of some.
But I don’t take pleasure in the failure of others. I don’t know the governor personally, but there is no denying his decisions have had consequences. I have seen the damage to my uninsured patients when the governor chose political ideology over pragmatic decision making. You supported the governor in his vision. But soon your own vision might need defining.
As you know, since federal Affordable Care Act passed in 2010, Kansas has lost well over $1 billion in potential funding. That money could have helped my patient Dave of Wichita stay out of the hospital. I saw him in the emergency room with uncontrolled diabetes and blood pressure so high we had to admit him just to lower it. He was unable to afford his medications since losing his job. The best I could do was avert his wife’s and children’s gaze as I provided him with some free drug samples and a phone number to a free clinic.
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That day I was ashamed that the state I’ve called home since the age of 10 couldn’t do more to help Dave. If Medicaid had been expanded, he would have insurance. But that wasn’t the case then, and it isn’t the case now.
And why is that, lieutenant governor? Why is Kansas shunning the citizens that need its help the most? If you and I ask this question of ourselves — ask as if we were standing in front of the almighty himself and only truth would get us our salvation — I would hope we both would agree the answer is politics.
But we are physicians and men of science, you and I. It’s evidence, not political ideology, that should loom larger in our lives. I could show you a study in the New England Journal of Medicine that demonstrated significant improvement in mortality when comparing states that expanded Medicaid to neighboring states that didn’t. Or how about another study from The Annals of Internal Medicine where mortality rate dropped when Massachusetts expanded Medicaid? We can even look at the study in the Journal of American Medical Association where Republican states Arkansas and Kentucky, with their Medicaid expansion programs, demonstrated increased use of preventative care and outpatient care, decreased emergency visits, improved diabetes management and self-reported health.
There is little doubt about the transformative effect Medicaid expansion has on patients. This is why the Republican-led state House and Senate overwhelmingly approved Medicaid expansion before it was fatally wounded by Brownback’s veto.
But the people of Kansas have shown they are above the politics — even if their governor isn’t. Polls done by the American Heart Association and the American Cancer Society show nearly two-thirds of Kansans disagreed with the veto, and 75 percent were in favor of broadening Medicaid eligibility.
It’s no surprise, then, that Brownback’s approval rating is 24 percent. He’s the third least popular governor out of 50 in the country, according to the Morning Consult’s Governor Approval Rankings survey.
Your own election, lieutenant governor, will be fast approaching. The people of Kansas will not respond kindly to a continuation of Brownback politics.
So think not of that, but rather of my patient Dave. Think of the nearly 200,000 Kansans who would get health insurance if Medicaid were expanded. Think of the oath you took in the lecture halls of KU, where you and I both sat as medical students. You may have the chance to do the right thing now for the Kansans we promised always to help.
Taimur Safder is a physician who graduated from KU. He conducts public health and health policy training at Harvard University.