- Associated Press - Tuesday, June 24, 2014

Here are excerpts from recent editorials in Oklahoma newspapers:

The Oklahoman, June 23, 2014

Outcry over Medicaid copays is unwarranted

Some Oklahomans on Medicaid could face higher copays next year. Critics are loudly decrying this possibility. Yet we doubt most Oklahomans will lose sleep worrying that a recipient might have to pay $4 for medicine.

The Oklahoma Health Care Authority, which administers Medicaid, faces a shortfall due to federal funding cuts. To help make up the difference, agency officials may raise the copayments that patients pay. Oklahoma Policy Institute, a think tank that promotes increased government spending, believes this is unacceptable. In a release issued last week, the institute declared higher copayments “would shift costs onto the poorest and sickest Oklahomans, make it harder for doctors to effectively treat patients, and cause greater health problems that will mean higher costs later.”

Sounds bad until you notice the actual copays under consideration. Currently, Medicaid patients have no copay for preferred generic drugs. Other copayments range from just 65 cents to $3.50 based on the total cost of the drug. Under the OHCA proposal, those copays could jump all the way . to $4. A Medicaid patient’s copayment for a doctor visit might go from $3 to $4.

OK Policy warns those small sums may be “more than many can afford.” Yet we suspect most Oklahomans, viewing these proposed copayments, have a far different reaction: That’s all?

In 2009, debt.org reports that 73 percent of individuals with insurance coverage through an employer faced a copayment for a doctor visit. The average cost was $21.53.

Keep in mind, those citizens are forking over their hard-earned money for a copayment and at least a share of their premium. That latter expense is one Medicaid patients don’t face. Debt.org reports the average premium costs for a family insurance policy rose 62 percent from 2003 to 2011. The expense jumped from $9,249 per year to $15,022. Although employers covered an average of 74 percent of the cost, the remainder comes out of an employee’s paycheck. Under Obamacare, those expenses are expected to only increase.

Even as they attack these minimal copayments, OK Policy officials argue the state should expand Medicaid. Yet the reason that slightly higher copays are under consideration is because the current Medicaid system is becoming financially unsustainable. That problem won’t be reduced should state officials dramatically expand the program.

It is argued that minimal copayments will cause Medicaid patients to delay treatment, leading to higher costs down the road. That’s debatable. But even if true, why should recipients be exempt from the same concerns that middle-class families face? Money doesn’t grow on trees for most Oklahoma households.

The think tank also cites a study claiming minor co-payments for Medicaid recipients “led to an 88 percent increase in emergency room use.” Left unsaid was the fact that Medicaid coverage, by itself, leads to higher non-emergency use of emergency rooms. A study published in the journal Science found individuals added to Medicaid through an expansion of Oregon’s program made 40 percent more visits to the emergency room than their uninsured counterparts. Most of those visits could have been handled at a doctor’s office.

Contrary to critics’ claims, OHCA’s proposal to boost patient copayments is not evidence of the need to expand the Medicaid program. Instead, it’s evidence of a simple truism: “Free” health care isn’t free.


Tulsa World, June 23, 2014

Legislature should strike judge’s ‘deliberative process’ exemption to the Open Records Act

A state judge has created a new exemption to the state’s Open Records Act, and thus made Oklahoma government more opaque.

Oklahoma County District Judge Barbara Swinton ruled last week that Gov. Mary Fallin was justified in refusing media requests for copies of internal governor’s office records concerning her decision to reject Affordable Care Act funding for Medicaid expansion. In response to media requests, Fallin had released some 51,000 pages of records, but withheld 100.

Swinton ruled the records were protected under a “deliberative process” exemption, meaning Fallin had the right to hear the thoughts of her employees without their fearing “public ridicule or criticism.” Swinton said that deliberative process is part of common law, but it is not specified in the Open Records Act.

Of course, ridicule and criticism - i.e., public scrutiny - of powerful state officials and their staff is exactly what the Open Records Act was created to ensure.

The law has a laundry list of specific exemptions, none of which mention the phrase “deliberative process.”

The law’s opening paragraph, states, “It is the public policy of the state of Oklahoma that the people are vested with the inherent right to know and be fully informed about their government.”

“Fully informed” now comes with a footnote: a judicially created exemption that is so broad that a talented sneak would be able to conceal the state Capitol in its entirety within it.

We hope the Oklahoma Legislature, which has had a good record on transparency issues in recent years, will clarify this issue for future judges. All they need to do is affirm that they said what they meant and meant what they said in the Open Records Act, and no other exemptions need to be added.


Tahlequah Daily Press, June 20, 2014

Suicide prevention bill may solve other problems as well

A bipartisan bill signed into law recently by Gov. Mary Fallin could give schools they leverage and resources they need to help thwart suicide.

If the initiative works, it could make giant strides in reversing an alarming trend in suicide among teens, and increasingly, among pre-teens. That’s especially important for Oklahoma, where the suicide rate per capita is the 13th highest in the nation.

House Bill 1623, which focuses on intervention for youth in grades 7-12, will provide training for both students and teachers on recognizing signs that might point to impending suicide attempts. Prevention is also part of the curriculum, which will be offered free of charge to school districts, under the auspices of the Oklahoma Department of Mental Health and Substance Abuse Services.

Rep. Kay Floyd, D-Oklahoma City, who co-authored the measure with Sen. A.J. Griffin, R-Guthrie, pointed out that suicide is the second-leading cause of death nationwide in the 10- to 24-year age bracket.

Records show that in 2012, 111 Oklahomans in that group killed themselves, and 91 took their own lives in 2011. Those numbers dovetail with statistics that show the state’s suicide rate has increased 20 percent from 2004 through 2010, according to Floyd. And the Oklahoma Department of Health says suicide is the most common violent type of death here, with 2-1/2 times more suicides than homicides.

It’s about time someone started paying attention. And it’s also about time that someone with the power to do something actually took the bull by the horns.

Beginning this fall, every school can offer the training program, and institutions can also contract with youth agencies to augment their own services. If a student is determined to be at risk, school officials will be obliged to contact the youngsters parents or guardians.

Possible drug use will be a key factor in this new program, as it should, because drugs play into a considerable percentage of suicides. And these drugs aren’t always illicit; some may be prescribed for legitimate reasons. But there’s a growing body of evidence that overmedication, or improperly prescribed medications singularly or in combination with others, can exacerbate mental illness - or even create one that didn’t exist in the first place.

It can’t have escaped the notice of any rational person that the vast majority of school shooters have been mentally ill, though in many cases, this was discovered only in hindsight. And many of the culprits wound up killing themselves before society could mete out its own justice.

With strong programs in place at schools, teachers and administrators should be equipped to help parents recognize the warning signals of impending disaster. The hope is that not only will it save the lives of the troubled youngsters, but the lives of any others they choose to harm during their distress.

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