Almost three years into Bentley’s four-year term, that campaign slogan appears more like a cruel joke than a pithy one-liner.
Alabama has a doctor/governor who in matters concerning health-care policy governs as if he spent his days swinging a sledgehammer instead of wearing a white lab coat. Show Bentley a solution that disagrees with his rigid ideology and down comes the hammer. Caught up in this mess are thousands of Alabamians too poor to afford health insurance but too well off to qualify for Medicaid.
Alabama’s great tragedy is that it didn’t have to work out this way.
In the 2010 race for governor of Alabama, the ink was drying on the Affordable Care Act.
Think of the possibilities of a state electing a physician as chief executive. Doctors have a deep level of understanding of the often-costly and inefficient beast we call the U.S. health-care system. They see first-hand the bitter cruelties caused by a maze of for-profit insurance companies balancing health care with the bottom line.
They can fill hours telling stories of how the system creates winners and losers. How the losers frequently find themselves in bankruptcy because of illness. How the uninsured are a drag on the system. How Washington politicians under the influence of powerful health-industry lobbies often create policies that do more harm than good. How the bad lifestyle choices of many Americans play a role in the nation’s poor health.
Perhaps, even more importantly, doctors are skilled at balancing risks and rewards. A patient with a serious ailment needs a medication that carries with it potential negative side effects. Precautions are important as is careful weighing for all outcomes, yet eventually a doctor must do what’s possible to save the patient.
Bentley has made his diagnosis on Obamacare, and in his view it’s completely awful. At certain points, he’s even described it as the worst law Congress ever passed. This patient, Dr. Bentley says, can’t be saved.
Other governors, even some who, like Bentley, are Republicans, have come to a different conclusion. They’ve reasoned that a law offering states an incredible bargain to expand Medicaid is worth the risk, both politically and/or in matters of policy management. They’ve decided to make the best of existing law.
Not in Alabama, where Bentley and most of his fellow Republicans in Montgomery have refused to play along with Obamacare even though the feds would pay all the costs of Medicaid expansion at the outset, and eventually the most Alabama would pay is $1 for every $9 spent by the federal government.
Without an expanded Medicaid, an estimated 308,000 Alabama residents find themselves lacking coverage they would otherwise have if our doctor/governor had chosen differently.
So, just what is Bentley’s alternative prescription?
“I don’t know how we can help them,” he told The Star. “I can tell you how they can be helped. If the federal government can repeal this law and start all over again, that’s how they can be helped.”
So, under his logic, the way to help Alabama’s working poor without coverage is to repeal a law that Bentley is refusing to participate in.
We think the doctor/governor should seek a second opinion.