John Oliver, the hilariously exasperated host of HBO's "Last Week Tonight," specializes in long-take satirical reporting, prodded by his status as a British transplant often boggled by the insane decisions made by our leaders.
Not surprisingly, that has led him to regularly probe our healthcare system. On Sunday he achieved what few actual journalists have--put faces to the rejection of Medicaid expansion under the Affordable Care Act (ACA).
Among those faces are 53-year-old Cathie Owen, a resident of Texas who said that "$8,000 stands between me and maybe another 20 years of my life if I have colon cancer." That's the price tag for a colonoscopy, and Owen is scraping her pennies together to have the exam because the disease runs in her family (no discussion as to what she will do if she actually has cancer). She described her plight on the verge of tears.
There was also Lashombee Hoard, a Mississippi resident and diabetic who often has to reuse her needles for injecting insulin because she cannot afford to purchase new ones. She was also shown about to cry.
As Oliver excerpted Owen's interview from Al-Jazeera America and Hoard's interview with the Mississippi Health Advocacy Program, neither were likely seen by a large enough audience to inspire the right person to help them out.
Those interview excerpts led to Oliver's examination of the Medicaid gap, created when many states decided to opt out of expanding that program under the ACA. That left millions of Americans earning too little to qualify for subsidized insurance on the state exchanges, and way too much to qualify for Medicaid under the penurious income guidelines set by the states they live in.
For laughs, Oliver equated this particular gap to those that sometimes occur when wearing gym shorts. Indeed, he made comparisons throughout the segment I actually cannot repeat here, although none match the horror of not expanding Medicaid.
In addition to obviously taking an emotional and physical toll on millions of low-income Americans, not expanding Medicaid costs hospitals billions of dollars a year and has no doubt contributed to some of their closures, pinching off healthcare resources for everyone.
Nevertheless, the state-by-state resistance to Medicaid expansion is mostly continuing unabated. According to an article published last month by the KHI News Service, a spokesperson for Kansas Gov. Sam Brownback suggested in a letter to his supporters that Medicaid expansion would merely be an award for people "who chose not to work." That may be the most noxious statement a politician has endorsed on this issue to date, and it went all but unnoticed.
Oliver went on to discuss how the future of expansion in three states--Kentucky, Virginia and Mississippi--could hinge on statehouse elections that are occurring this week. Mississippi almost certainly won't expand coverage because an anonymous truck driver is the Democratic challenger against Gov. Phil Bryant (not to mention the perverse pride Mississippi seems to take in not helping their most vulnerable residents). But a Republican challenger in the Kentucky gubernatorial race has pledged to roll back Medicaid expansion if elected, even though Kentucky has been the most successful state in the country in reducing its rate of uninsured residents. And in Virginia, a single legislative seat up for grabs could make a difference in its decision to expand coverage. Both races are tossups.
Oliver often ends his show with a pungently funny gimmick or practical joke as an overarching retort to the inanity he's just reported on. Earlier this year he created a cowboy hat-wearing mascot called "Jeff the Diseased Lung" to replace the legendary Marlboro Man. It was meant as a rebuke to Big Tobacco for fighting against the placement of graphic warning labels on their products.
I tried as a gimmick of my own to track down Cathie Owen and see if I could provide assistance either obtaining a cheaper colonoscopy (around $2,000, which is much closer to the actual retail price), or persuade a hospital to provide one under its charity care program. Unfortunately, the closest I could get to her was a self-described "ex-ex-husband" who did not know her whereabouts.
Instead, I suggest Oliver create a new mascot--the Medicaid Expansion Zombie. It would represent the tens of thousands of Americans who have no doubt died over the past several years because they were denied access to timely care due to the misfortune of residing in the wrong state.
Having risen up from their avoidable deaths, Medicaid zombies could then extract vengeance by eating the brains of the lawmakers who shut them out of medical care because they insisted they didn't want to work--all the while ginning up the votes to help keep their own jobs.
I suppose it will be a challenge to locate those brains. But zombies are nothing if not persistent. – Ron (@FierceHealth).