At some junctures things don’t work out due to timing. At other points the strength of circumstances significantly shapes perspective and crystallizes options. Such a moment is upon us regarding the question of Medicaid expansion. The state is being offered the means (through the Affordable Care Act) and it already has the way (AHCCCS) to ease Arizonans’ increasing financial strain, bring hospitals back from the brink, improve health and well-being for 300,000 residents, and keep economically Arizona competitive in the region. Can there be any question that timing is everything?
St. Luke’s Health Initiatives formally joined the chorus of advocates for expanded coverage and access by publishing Arizona CAN in 2004. Nearly ten years on, the analysis remains compelling and its principles ring true. Coverage and access to affordable and culturally appropriate care matter. Financing for it should be responsibly shared by the public sector, private sector, and the individual. Barriers to effective and affordable care must be reduced or eliminated. Almost ten years later, Medicaid expansion implemented by AHCCCS can deliver a solid step forward towards realizing those principles.
Expansion isn’t THE answer, but that’s no reason not to move forward with it. There is no quick, easy or comprehensive single fix for what ails our health care system. Compellingly simple arguments against disruptive and risky change are hypnotically attractive because they defend the seemingly safer status quo. Unfortunately, the status quo is actually dangerous on a number of levels. Just like those objects in your car’s rear view mirror, the full extent of the system’s problems are larger than they might appear, and we can better solve them when the problem of coverage and access is handled first.