Why a conservative voter supports I 185

Health care providers strongly back I 185. Doctors wish to see their patients smoke less and enjoy better health care. I 185 does both things. It makes cigarettes less affordable through a hefty tax. It also ensures health care for 100,000 working Montanans. As a doctor, I share those sentiments. However, I am also a conservative voter. I have spent years fighting to oppose government-run health care. Why as a voter, do I support I 185?

When we tally up other government funded programs including Medicare, Medicaid, the VA, workman’s compensation, Children’s Health Insurance Program and others, the government extends a guarantee to a majority of people. The government funnels gigantic amounts of money into health care. This fact has profound impact on how we deliver health care, and therefore, how much it costs. Consequently, health care costs have risen faster than almost anything else because of the giant infusions of government money into the system.

When the Affordable Care Act was passed, both sides agreed on two things — that there were too many uninsured Americans and that rapidly rising health care costs were already too high. Even conservative think tanks like the Heritage Foundation worried about what people called “the Medicaid cliff.” They referred to the fact that the income offered by low wage jobs was enough to disqualify someone from traditional Medicaid but was not enough to buy private health insurance. This was the problem that basically everyone wanted addressed. The Medicaid expansion is meant to address this critical problem. Although the U.S. Supreme Court upheld other more dubious parts of the ACA, it ruled that the states must opt into the Medicaid expansion. Typical of Washington, the only thing that really needed to get done didn’t, while everything else did. Our Legislature did opt-into the Medicaid Expansion in 2015 but, despite the robust enrollment of 10 percent of Montana who couldn’t otherwise afford health insurance, there is great concern that that program will not be renewed in the next legislature. One conservative Legislator said that the results of ballot measure I 185 will be seen by the Legislature as a referendum on the Montana Medicaid expansion.

If Montana does not pass I 185, 100,000 Montanans will likely become uninsured. The lost revenue will strain our already strained hospitals. If the uninsured do get care, the costs will inevitably be shifted onto others. The people at risk are ordinary Montanans. These people work hard for low wages. They support their families and contribute to society. Often they own or are employed by one of Montana’s many small businesses who can’t provide health insurance. Meanwhile, people who qualify for nearly free government health care programs may make more money, be retired with resources, or be chronically unemployed. See the inequity? An 80-year-old retiree can take six medicines, get a new hip, and two new knees, all paid for. A prisoner in Deer Lodge, no problem, free back surgery. A waitress at my favorite restaurant, two jobs, two kids, no husband? Shall we tell her “too bad, we have decided to limit government health care?”

I plan to continue to advocate for health care reform. I will try to advocate for reduced government involvement, for a more affordable market based system and for a health-system which responds to the consumer, not to big government and corporate America. This is a generational battle which will be decided at the Federal level. With massive government subsidy in the marketplace, health care will remain unaffordable. Until we untangle the Federal mess, I will stand up for hard working low income Montanans. Even if you are a conservative, I hope you will stand with me and support I 185.

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Dr. Carter Beck, M.D.

Missoula