We, Oklahomans, demand that our elected leaders be dedicated to finding common ground to serve the common good. Employees are the most valuable resource we have. Oklahoma is at a critical point. Will we let rural areas die, or will we provide the quality national services needed to save them?
Around 2017, many of our rural communities turned to private, for-profit health services for quality, affordable and accessible healthcare. They found that those companies filed for bankruptcy and left the state when they failed to meet their profit targets.
Had Oklahoma been part of the Medicaid Expansion Program from the beginning, this could have been avoided. It would have provided a stable financial base for low-income households in rural areas. Finally, a vote on June 30, 2020 approved expanding Medicaid to provide health care to low-income adults aged 18 to her 65. program. The Medicaid expansion is 90% funded from federal funds. With this increased investment of new funds in the state, Oklahoma could have provided a stabilizing factor to rural communities, not only by improving healthcare, but by bringing home federal dollars to boost the economy. The administrative fee for the state to run this program is between 3% and 4%. General Medicaid administration costs are 50% federal and 50% state funded, but there are 20 Medicaid administration matching formulas.
Shortly after the Medicaid expansion was approved, Gov. Kevin Stitt set out to privatize its administration. He has contracted with three companies to run the program. This included allowing him 15% of administrative costs and required the program to operate under managed care standards. Medicaid Managed Care provides Medicaid health benefits and additional service offerings through contractual arrangements between state Medicaid agencies and managed care organizations (MCOs). The cheapest healthcare they offer, the more profit you can make. These contracts fell through because the courts determined they were not handled properly. That didn’t deter our leaders. The governor and legislature have passed a bill that will make contract managed care available starting in 2023. I don’t think managed care is the best way to pay for health care, but states may run programs like managed care. profit.
The availability of quality health care depends on the availability of well-trained health care providers. Many people prefer living in rural Oklahoma. We need to surround them with the services they need to enable them to thrive on the spot. Quality public education is the foundation of democracy and a thriving economy. We must provide quality public education, from birth to living wage career achievement, including farmers, welders, nurses, doctors and more. We do that by identifying each student’s potential, feeding them throughout the educational process, and enabling them to work where they want to live.
Finally, you have to work outside the silo. Health Service in India is a vital medical service in our local counties. Countries should coordinate and cooperate with these services. We also need to strengthen public health and mental health care systems. And every Oklahoma citizen should be able to access triage services with special care available only in more densely populated areas.
The co-product of addressing all these issues, if done right, is a significant reduction in poverty in Oklahoma.
Marilynn Knott is a retired Oklahoma Department of Social Services administrator for planning, policy and research and is currently on the policy team for the Oklahoma Campaign for the Poor.
