There’s a passionate Perspectives in this week’s NEJM that’s worth a read. Charles van der Horst was recently arrested for protesting against his state’s refusal to expand Medicaid. He hits all the high notes of what that decision means for the citizens of his state, and the patients he cares for. I’d like to highlight this paragraph:
By willfully rejecting a Medicaid expansion to thousands of hardworking North Carolina families, our state government was consigning these citizens to the same fate as many patients I’ve cared for during research and service projects in Africa — dying needlessly for the lack of appropriate preventive care. North Carolina has high infant mortality (a measure on which we rank 46th in the country), a high rate of low birth weight (40th in the country), and a high prevalence of diabetes (36th). We rank among the bottom 20 states in terms of premature deaths (36th), cancer-related deaths (35th), and deaths from cardiovascular causes (31st). We are not a healthy state. With so many poor medical outcomes that can be prevented through access to good care, how can we not protest the decision to deny several hundred thousand North Carolinians access to health insurance? And how can my colleagues in the 22 other states blocking Medicaid expansion not speak out as well?
It’s a fair question.