Here’s the update:

Covid-19 is pushing red states to finally expand Medicaid

All I can say is, it’s about time.

As things have turned out, expanding Medicaid to cover more poor folk was probably the smartest thing a state could do, healthwise. Particularly in view of what has happened since.

Oklahoma and Missouri are simply the latest to catch on. With expansion, 200,000-plus underprivileged persons in each state will have improved access to healthcare. If you work in public health, you can breathe a sigh of relief. Now when people in need show up, whether at the clinic, in the ER, or in the hospital, there are funds available to help defray the cost.

In the past decade, we watched as the opioid epidemic just kept growing. Prescription painkiller users eventually became street heroin users, often switching to intravenous use. That put us back in line for a resurgence of HIV and AIDS. Then, just as OD rates began to respond to widespread use of naloxone and other interventions, fentanyl made its appearance. OD rates jumped again, often involving individuals who thought they were using ordinary heroin, coke, or methamphetamine.


By the way, here comes another synthetic, street name Iso. It won’t be the last. A link: Iso: The New Synthetic Opioid That Is Causing Overdose Deaths

All this should have made it even more abundantly clear that Medicaid or the equivalent was badly needed. Still, there were holdouts.

Now we have a coronavirus pandemic — one that was long anticipated by scientists — to drive the point home.

It was easy for some to dismiss the consequences of the drug epidemic when they were largely confined to drug users. Many Americans still consider that a subclass. It’s not so easy with COVID-19.

You do hear people argue that because they’re younger and still healthy, they’re not in danger. “It’s just the flu,” they tell you. “I’ll ride it out.” Sometimes they get away with it, others times not. There are likely longer term consequences. With a ‘novel’ illness, we’re never quite sure.

As Dr. Fauci reminds us, it’s the virus that charts the course and sets the timetable. We’ve been dreading a second wave in the Fall, but experts say it’s really more like a wildfire, one that seeks fuel wherever it finds it. That fuel is people. Worse yet, many who spread the disease seem not to realize they have it.

Medicine isn’t sure why some people get sicker than others, but we know they do. Even children, supposedly not at risk, can be carriers.

Well, why should that surprise us? They bring home a host of other illnesses.

It appears that Missouri voters approved Medicaid expansion over the objections of the political powers that be, who are mostly hard-liners. I grew up in western Missouri, a couple hundred yards from the Kansas line, so I know exactly how resistant folks there can be to change. Even the necessary sort.

Props to the voters. Better late than never.