This July, Tim Eberlein, MD, Chair of the Department of Surgery and Bixby Professor of Surgery, spoke to St. Louis Public Radio about Medicaid Expansion, encouraging Missourians to vote yes on Amendment 2 during Missouri’s Aug. 4 primary.
Amendment 2, which was passed into law, will expand Medicaid access for low-income adults ages 19 to 64. This expansion makes it possible for Missourians with low income to access important medical care and screening, which could save lives and reduce the mortality rates of the deadliest cancers for people in Missouri.
“I’ve had the opportunity to personally care for patients who are hardworking Missourians and who face a stark contrast of either feeding their family or getting health care,” Eberlein says.
Speaking to St. Louis on the Air, Eberlein notes that Medicaid Expansion would help those who need it most: “People who are playing by the rules, working hard,” but who lack the health benefits to receive treatment or screening.
When a person cannot afford treatment, screening or prevention modalities, their disease is likely to worsen before they present to a doctor for treatment. For Eberlein, who is also the Director of the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, this is particularly apparent in cancer patients.
“In all 50 states,” Eberlein illustrates, “[there] are approximately 3,000 counties, and if you were to rank those counties by mortality due to cancer, four of the top six counties in the entire United States of America are here in Missouri.”
With Medicaid expansion, more uninsured or underinsured Missourians will have access to health care that could help prevent or detect diseases such as breast or colorectal cancer much earlier, meaning that the cancer could be treated before it metastasizes. Early-stage cancer that has not spread to other parts of the body can be more easily treated, and is much more likely to be cured, whereas late-stage, metastatic cancer requires more expensive and invasive treatment, with a higher mortality rate.
“It’s tragic that, in 2020, a person comes in with metastatic cancer because they did not have access to screening and prevention modalities,” Eberlein states.
Siteman is an international leader in cancer treatment, research, prevention, education and community outreach. It is the only cancer center in Missouri to hold the prestigious Comprehensive Cancer Center designation and “Exceptional” rating from the National Cancer Institute and membership in the National Comprehensive Cancer Network. Eberlein emphasizes that, as a “safety net” organization, Siteman and parent institutions Barnes-Jewish Hospital and Washington University School of Medicine provided almost $50 million of free care to uninsured or underinsured patients in 2019. Bringing more tax dollars back to Missouri through Medicaid expansion could lead to even more patients receiving the highest quality cancer care at Siteman.
“These are tax dollars that Missourians have already paid,” Eberlein says. “Not only would those dollars come back, but there would be a higher reimbursement rate for patients who meet Medicaid or Medicare reimbursement. The program would actually pay for itself.”
Medicaid expansion also benefits patients with chronic diseases, such as diabetes. A diabetic patient who works on their feet and develops a diabetic foot ulcer faces a challenging recovery process. “That can lead to costly, long term medical interventions,” Eberlein says, “and may result in an amputation, which will further jeopardize their employability.”
If that patient has access to health care to manage their condition, treat their ulcer, or receive necessary surgery in a timely manner, they may be able to avoid amputation and the further challenges it presents.
“The passage of Amendment 2 is a tremendous victory for a quarter-million Missourians who no longer have to live in fear of getting sick or hurt because they will now have healthcare coverage when they need it,” say David H. Perlmutter, MD, Executive Vice Chancellor for Medical Affairs and Andrew D. Martin, PhD, Chancellor of Washington University in St. Louis, in a statement to the Washington University community. “In addition to improving access to life-saving care for our most vulnerable citizens, Medicaid expansion will inject billions of dollars into our economy, create thousands of new jobs and benefit communities across our state at a time when it is needed most.”