The destruction of Obamacare would hurt Michigan students


Studies show that healthy children perform better in school. Deep cuts in Medicaid funding from the demolition of the Affordable Care Act could leave tens of thousands of Michigan kids without health care.

Ron Koehler

Ron Koehler is assistant superintendent of the Kent Intermediate School District.

Lost in the debate surrounding the attempted repeal of the Affordable Care Act is the potentially disastrous effect dramatic reductions in Medicaid funding will have on health care for children, one of the few universally recognized success stories in health care coverage over the last 20 years.

In 1997, after rejecting the universal health care reform proposed by then President Bill Clinton, Congress coalesced behind the Children’s Health Insurance Program on the consensus that early health care is critical to children’s future success. In the succeeding 20 years, the uninsured rate among children has fallen from 14 percent to less than 4.5 percent.

Combined with increased Medicaid coverage and the extension of health care to millions of uninsured through the Affordable Care Act, the percentage of children who are uninsured has fallen dramatically. Georgetown University’s Health Policy Institute reports the impact of extending insurance to parents is so great that “a child was eight times more likely to have public insurance if their parent had public insurance, when compared to a child whose parent was uninsured.”

While the impact of poverty on educational performance remains a subject of debate, the effect of health care on student performance is not.  A Seattle survey conducted last year found that “fewer than 15 percent of students with zero health risks were at academic risk, (but) more than half of students with 11 or more health risks were at risk of failing.”

The Georgetown University Health Policy Institute concludes: “The most profound impact of the cuts to health coverage could be a decline in student achievement. Research shows us that students eligible for Medicaid are more likely to graduate from high school and complete college than students without access to health care.”

Children with chronic pain, dental neglect and other health concerns cannot focus on their education. In our community, philanthropic organizations led by the Grand Rapids Community Foundation more than a decade ago came together with the county, schools, health and human service agencies to create the the Kent School Services Network.  KSSN provides an array of health and human services for students and their families directly in the school building, using community school coordinators to identify issues impeding student. Medicaid funds are used in these settings to provide health and human services to qualifying students.

KSSN, a model for Governor Snyder’s Pathways to Potential program, and other programs like it have been so successful that policymakers now consider these strategies as evidence-based interventions for school improvement planning and reducing achievement gaps for ethnic and economically disadvantaged student populations.

Deep cuts in Medicaid funding contemplated in the repeal and replacement of the Affordable Care Act could result in the loss of health care for tens of thousands of children in Michigan, and it could also force legislators to scale back the Children’s Health Insurance Program, especially if funding is reduced or curtailed by Congress when the program comes up for renewal in September of this year.

Our children deserve better.  Children who are in pain, without treatment, or children who suffer the strain of family members with untreated disease or illness, do not have the same opportunity to succeed as those who are free of those burdens.

Michigan’s recent ranking in the national Kids Count assessment of children’s well-being was 32nd among the states. Access to healthcare was one of the few bright spots, with a state ranking of 17th. Our educational performance was 41st.

We cannot afford to fall backward. We must improve educational performance if we are to restore any portion of Michigan’s past prominence as the engine that drove the nation’s economy. Accessible and affordable health care is essential to the success of our children, to our employers, and to our economy.   

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Thu, 08/03/2017 - 7:48am

We seem to have a fixation on the number of people that are insured, which IMHO is incorrect. Medicaid numbers in the state are approximately 25%, when in a healthy economy, they should be closer to 10%. If we keep on this trajectory, we will soon be that the minority of people are paying to insure the majority. This is not right.

Healthcare costs should be where our focus is directed. The US pays approximately 10,000 per citizen per year for healthcare costs. The next largest spending country pays about $5,000 per person per year, and according to the judgement of the experts, that country enjoys better healthcare than the US. If the results were improved and the costs were reduced, the payers would not resist so much and people would be healthier. It is wrong to continue down a path that thinks throwing money at a problem will fix the problem.

Would it be easy to reduce costs? Yes it would. There have been many essays written with very good suggestions on how to achieve cost reduction. The problem is that too many are fixated on just one number, the number of insured, while the real problem goes unaddressed.

Kevin Grand
Thu, 08/03/2017 - 4:00pm

The real problem goes unaddressed, Rich, because there are too many people whose financial self-interest is hitched to keeping the costs where they are at instead of reducing them (i.e. big pharma, insurance companies & hospital chains).

Another problem here is that there is a growing political philosophy in "BOTH" political parties that wants to have greater control over the individual lives of Americans. Part of maintaining that control involves requiring the transfer of wealth from one class of citizen over to another. What even the most fervent Obamacare supporters will not acknowledge is that eventually that money runs out and you have a situation like Baby Charlie where they pull the plug on your care because it's not "cost-effective" to the system as a whole.

And yes, we even have that over here; we call them IPAB's.

Not even a generation ago, the idea of the government making you purchasing a service as a condition of citizenship was unthinkable, which is why Hilarycare went nowhere.

Pres. Trump hit the nail right on the head when he said that because of Obamacare's rising costs, rising deductibles and lower coverage (so much for the "If you like your plan/doctor you can keep them"-argument), that the best thing to do is to let the whole things crash and burn.

Maybe then the politicians will take notice?

Maybe even someone at The Bridge?

Robyn Tonkin
Fri, 08/04/2017 - 1:32pm

I am a sixty three year old woman, with a lot of overlapping avenues to excellent low cost health care via Tricare and FEHBP. When I was a child, growing up in Trenton (which, if you don't know, is a small city in the Detroit metro area) twice a year, we stood in long lines in the school foyer to receive Public Health Service provided vaccinations and dental fluoride treatment. I had health insurance and dental coverage through my dad's employment with Detroit Edison, but my mother always signed me up for at least the fluoride treatment. Participation in these programs was seen as a civic duty. I remember one summer day after church, going to the center of town, to stand before phalanxes of long tables, draped with linen tablecloths topped by hundreds of paper cups containing the oral polio vaccine that was nationally mandated. Nurses in starched uniforms stood behind the tables, ready to hand you your dose. No one would have thought of skipping this event, it was a national duty to participate.

That Americans did not participate willingly in group activities targeted to the greater good of all is a fallacy promoted by people who don't want to help pay for universal health care coverage. Americans acting together as a cohesive unit was seen as a great power for good in earlier times.

People seem to think that the "frontier" was only a lawless placed for those who wished to have no higher law than the whim of the individual. This is completely incorrect. As a first step, as settlers moved into an area, a teacher was hired and a public school set up. A stated aim of the school was the inculcation of social norms into the young, and a point of cultural assimilation for the children of immigrants. Speaking of immigrants, most immigrants who settled in urban areas soon established burial societies and benevolent societies, to pay for final rites and to support and aid the widow and orphan and disabled in the group. That Americans were lone wolf rugged individualists is simply one tiny corner of a story whose greater part is one of banding together for common good.

It is my belief that when the Affordable Care Act was enacted, forces who do not wish for universal care for all bided their time, and then worked in coordinated ways to insure its hobbling and eventual failure. Americans, in any event, want universal health care with a single payer. My husband, who was in the military for 42 years, obtains his care from the VA, and cannot say enough good things about the VA, which is a single payer system with the US govt. as payer.

One argument used both for and against the Affordable Care Act is the absence or presence of the ability to "keep your own doctor." My healthcare is provided to me in a typical clinic system, and I dearly wish I could be in the VA with my husband, but I am not a veteran. My doctor, who I carefully chose as the best around, is a nice overworked man who hews closely to the Best Practices Doctrine. He is intelligent, kind and fairly sharp, but completely interchangeable with other doctors. I think ever since the American psyche was trained to revere the likes of Dr. Kildaire and Marcus Welby, MD, Americans have hoped to find these guys in the office, or at least their spiritual equivilents, lab-coat firmly in place, mind working feverishly to make that obtuse diagnosis just in the nick of time. This isn't reality. Finding somebody reasonably willing to spend time thinking about what is wrong is the best that you can hope for, and those types are to be found wherever you get your care.

Kevin Grand
Sun, 08/06/2017 - 6:49am

Interesting piece, Ms. Tonkin.

You've completely danced around the underlying problems that Americans have with health care right now (i.e. rising premiums, higher deductibles and oh yeah...consistently rising health care costs themselves), but whatever.

Now a lot of people are happy that they have a nice shiny plastic card in their wallet, paid for by someone else. I've obviously missed that part in Civics where they went over how the government had that power, but again whatever.

Than been said, would you care to explain how Obamacare care actually addresses those increases I've mentioned above?

Because I, and a great number of American, do not see it.

And unless Obamacare can do that, it will inevitably collapse.

Allan Blackburn
Tue, 08/08/2017 - 12:51pm

As a healthcare CEO for a quarter of my life there are many misconceptions and political points here that have no basis in reality. The argument about keeping your doctor is a red herring. To claim Obama lied because he assumed this was a probability which didn't work out is the same as saying that Trump lied while he claims everyone will be covered. A president is a president, not an insurance expert, a healthcare CEO, or health policy expert. A competent president will acknowledge their limitations and ensure they have the necessary experts representing all aspects of healthcare and funding mechanisms to come up with the best plan to insure the most amount of people will be covered with essential benefits. If you want to go back to lower deductibles get rid of essential benefits and go back to selling crap plans which will bankrupt people when they really need a service the plan doesn't cover; i.e., hospitalization, behavioral health, substance use disorders, organ transplants, Hepatitis C treatment, chemo, etc. There are many things which have caused deductibles to increase including Medicaid not expanding in all states, intentional sabotage in not paying out risk corridor funding guaranteed to insurance companies for offering plans on the exchanges without foreknowledge of who would sign up for the plans, inability to negotiate healthcare and pharmacy costs, etc. I had over 30 employees that I paid for insurance for, including their families and our costs went up by double digits every single year. Unfortunately many have come to the idea that their piece of socialism is okay but not for anyone else. Say an individual who works multiple part-time jobs and none of them provide insurance coverage, yet the dog whistle is they are lazy, made poor choices, etc. and are undeserving of any healthcare. Maybe our best option is to cease all employer provided insurance coverage and we all end up in the same market. Unfortunately we aren't there for socialized medicine yet so we have a free market system which is profit based and includes shareholders. If we were bold enough to have that conversation we might begin to negotiate pharmaceutical prices and healthcare costs. We also have to figure out the moral value we place on each other. We seem to have accepted the notion that we can never give away enough tax cuts to the already richest among us yet we balk at helping those less fortunate. We claim to be protective of life and then it springs from the womb and all bets are off. I suspect if we really wanted to solve this issue we could do it. It just might take some work and some compromise and the realization that, when it comes to healthcare, there shouldn't have to be winners and losers.

Robyn Tonkin
Fri, 08/04/2017 - 2:39pm

As a young couple with one child, my husband and I had to budget closely as he did not make much as a forester with the US Forest Service. In resource management, you get to live in beautiful remote places, but the pay is very average. I always budgeted for routine dental care and health care. We had health insurance, but all dental care other than emergency care was our responsibility and we had sizable copays and deductibles on health care. As a young adult enlisted person in the Navy, our daughter always availed herself of all dental care that was offered. The dental care team always asked her how to get more people her age to avail themselves of the prophylactic cleanings and fluoride treatments and xrays. She didn't know how to help--it did not occur to her to NOT get her teeth cleaned and checked every six months. This illustrates a very important side issue to adequate childhood dental and wellness care--by beginning routine care in childhood, you are establishing positive patterns of proactive healthcare behavior for life.

John Gorentz
Mon, 08/07/2017 - 10:17pm

Wouldn't it be nice if somebody showed some concern over the sustainability of the various government health-care programs?