May 10, 2016

Working together, we can solve New Mexico’s health care crisis

Pete Campos is a Democratic state senator who represents the state’s 8th Senate District.

New Mexico’s health care crisis demands our attention. Now.

PeteCampos2No person should suffer even one day of serious illness or injury because that person cannot find or afford to pay for good health care, yet that is exactly what happens each day in New Mexico.

Months-long waits for medical appointments, hours-long drives to Albuquerque or across the state’s borders once appointments are made and the worsening shortage of health professionals throughout New Mexico are becoming routine and, sadly, expected. These and other problems will only get worse if state officials cut payments to doctors and other health care providers who provide services to Medicaid patients.

This is a complex dilemma that is not unique to New Mexico. The fact that policymakers, medical providers and patients in other states also face this challenge is of little comfort, although we can benefit from their experiences. We must work together, diligently and methodically, bringing people together, to solve this crisis.

We face some unique challenges in New Mexico.

  • More than 78 out of 100,000 Rio Arriba County residents die of opioid overdoses, more than triple the statewide rate, which is already among the highest in the United States.
  • More than one-third of New Mexicans are enrolled in Medicaid and the federal Children’s Health Insurance Program. Those patients face long waits for primary and specialty care across the state. Twenty percent of New Mexicans live in poverty, which is as much a health issue as an economic issue.
  • While the Affordable Care Act has significantly reduced the number of people without health insurance in New Mexico, more than 13 percent of New Mexicans were still uninsured in early 2015.
  • Most of New Mexico — the fifth largest state geographically in the United States — is officially considered to be a “health professional shortage area”, short more than 163 primary care providers. Not surprisingly, physicians who do work in New Mexico do so in urban areas.

It is that shortage of health care professionals that has led to what I expect will be a temporary closing of the obstetric and pediatric unit at Alta Vista Regional Hospital in Las Vegas. This unit, along with local midwives, provides an important service in northeastern New Mexico. I’m confident it will reopen, and I will do everything possible to help recruit and retain physicians and nurses to ensure that that happens quickly.

Some of the proposed solutions to New Mexico’s Medicaid funding crisis threaten to exacerbate our health care professional shortage. We’ve significantly increased Medicaid spending over the years, but we still face a shortage of tens of millions of dollars in state funding for the fiscal year that begins July 1. The state funding shortage grows to hundreds of millions of dollars because we won’t receive federal matching funds.

An understandable, although misguided, solution proposed by state officials to this dilemma is to cut the payments that are made to doctors, hospitals, clinics and others who treat Medicaid patients. This short-term solution will create long-term problems as doctors leave the state and clinics close, worsening our health care crisis and further weakening our economy.

Instead, we should listen to providers who have offered solutions that have worked in other states, such as imposing new taxes on providers and dedicating that revenue — and the matching federal funds that would come with it — to fund Medicaid. At the same time, the state should enforce its contracts with Medicaid managed care organizations (MCOs) to ensure that the millions of dollars we pay them every year actually result in better health care. If the MCOs meet their obligations to provide care coordination, emergency room diversion and chronic disease management, Medicaid costs will not rise as fast. Providing the right amount of care at the right time will, as the state Human Services Department has promised, save millions of dollars.

None of this will be easy or quick. Policymakers, state officials, managed care organizations, health care providers and patients must work together now with the goal of improving access to affordable health care in New Mexico. This cooperation may be initiated at a series of regional town halls convened by New Mexico First or the regional health councils. We could build on these town halls with a statewide summit where the public, policymakers and experts formulate health policies that will address our needs. Doing so will make for a healthier, more productive society that will benefit all of us.