Letters to the Editor - Medicaid expansion in Texas, Affordable Care Act, Social Security, prevention, equitable treatment

Explain Medicaid refusal

Re: “Texas needs Medicaid expansion — There’s federal money to pay for the shift that public opinion supports,” by state Sen. Nathan Johnson, Wednesday Opinion.

Johnson’s essay lays out all of the reasons Texas needs Medicaid expansion. Seriously, can Gov. Greg Abbott give one reason for his refusal — other than a pigheaded refusal to adopt any part of the Affordable Care Act?

Linda A. Wilkins, Irving

Medicaid and the pandemic

Thanks for publishing Sen. Nathan Johnson’s column on the need for Medicaid expansion. If Texas had allowed Medicaid expansion when it became available, or if the politicians would accept the federal money for Medicaid expansion now, they would be showing themselves on the right side in the war against the pandemic. As it stands, with free federal money for Medicaid expansion not used, the Texas politicians are showing themselves on the side of the pandemic and against the people.

Johnson is correct, and you were right to publish his article.

Gene Lantz, Dallas/Oak Cliff

People of color and COVID-19

President Donald Trump expressed surprise at Tuesday’s news conference that people of color were more likely to die of COVID-19. He indicated that the reasons for this needed to be found. How is it that the president does not know that people of color are more likely to suffer from diabetes, heart disease and other health problems that put them at greater risk if they contact COVID-19?

These heath problems are more prevalent among people of color who also many times suffer from greater financial distress. They do not have easy access to health providers or insurance to cover their health costs. They often may be going without needed medication and medical procedures due to lack of funds. So, President Trump, it is not a mystery why people of color and any citizen who lacks good health care is more at risk for death due to this virus.

Many of us have been aware of the need for better medical care for people living in poverty for a long time. That is why we support the Affordable Care Act and expansion of Medicaid. America will never be great until all citizens are assured of adequate health care.

Phyllis Vaughn, Sherman

Remove payroll tax cap

Re: “Layoffs, tax holiday to squeeze Social Security — Anxiety grows for national safety net already in a crunch,” Sunday news story.

The latest article on Social Security mentions three things that need to be done to protect Social Security: higher payroll taxes, raising the retirement age and delayed cost-of-living adjustments. All of these affect low and moderate wage earners disproportionately.

It seems to me that there is a fourth option that is so obvious, yet I never hear anyone talking about it. Why not just remove, not just raise, the cap on payroll taxes? It won’t affect low and moderate wage earners who have already been paying a disproportionate share of the tax. It would require upper income wage earners to pay more, which is probably why it is never considered.

I’m not an economist so I don’t know how to calculate the effect of eliminating the cap on payroll tax would have on the overall Social Security budget, but surely it would mean more income for Social Security and ultimately a more secure retirement for our senior citizens.

Tom Naylor, North Dallas

Look at the German system

Re: “It’s time to refocus on health care system — Before we enact changes, we must shift priorities from treatment to prevention,” by Emerson Smith, Tuesday Opinion.

Smith rightly suggests that the health systems need to refocus on prevention rather than sick care. Here is how that can happen.

First, Americans need universal access to health insurance, modeled after the German model wherein the federal government enables insurance companies to insure everyone. Second, those insurance companies must be not-for-profit. American health care has shown that the profit motive thrives when providers make more money (and charge more) when people are sick, rather than healthy.

Third, prevention works better when health care organizations are responsible for defined populations of people, not just the folks who come to them when ill. Examples of such a model already exist in many parts of the country and are already lowering costs and improving health. I’m hopeful that the American public is ready to make such a change.

Keith Martin, M.D., Dallas/Kessler Park

Revive Affordable Care Act

Wasn’t this — pivoting to emphasize preventive care — the whole objective of the Affordable Care Act? Wasn’t that the right goal, which unfortunately has been systematically undermined and dismantled? Maybe it’s time to do a review of that intention to pursue this very initiative.

Denise Bumford, Dallas

Grateful for equity care plan

Re: “Ensuring that medical treatment is equitable — If hospitals in North Texas must ration coronavirus care, they have a plan,” by Brian Williams, Monday Opinion.

Racial and economic inequities in health care are not new to Dallas. We have seen it in Parkland’s community needs assessment and Children’s Beyond ABC report. And COVID-19 will most likely elevate those inequities just like some of our neighbors are being harder hit by economic fallout than others.

However, as noted in Williams’ op-ed on the North Texas Mass Critical Care Plan, we should all recognize, and be grateful for, the steps Dallas County is taking to ensure that when decisions have to be made about allocation of limited medical resources, they are made with equity in mind.

By staying home and using physical distancing we are helping to decrease the likelihood that North Texas will run out of ICU beds or ventilators, but that may still happen. And if it does, the Care Plan that Dallas County developed over 15 years ago for a potential disaster just like this one will make sure that what matters in determining who gets those resources is based on medical research and prognoses to save the most lives, focused on those with the best possible outcomes and to do so equitably.

Let’s keep that focus even after COVID-19 is gone.

Dena L. Jackson, Dallas

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