OPINION: Proposed Medicaid cuts will drive up health care costs

My name is John R. Vigil, MD. I am a practicing physician in New Mexico and have practiced medicine and surgery for over 30 years now. I am board certified in addiction medicine and for the last 20 years have been treating New Mexicans suffering from substance use disorders or addiction and co-occurring mental health disorders. I am also the founder and past president of the New Mexico Society of Addiction Medicine in 2013 and its current treasurer.

As a practicing physician in the front line and in an impoverished state, I am deeply concerned about the passage by the House of the reconciliation budget bill which will cut billions of dollars from Medicaid and remove millions of people from the Medicaid rolls.

The first people who are going to be affected by the Medicaid cuts are the already marginalized people who desperately need health care: the homeless and the millions of people struggling with mental illness and substance addiction. If this bill is made into law, we will watch overdose deaths skyrocket as the people who are currently doing well in treatment are kicked off the Medicaid rolls as they will not be able to afford the medications, the rehab costs and the doctor and therapist visits that keep them well and productive members of society. They will start flooding the emergency rooms for acute and expensive care. We will see the crime rate exponentially rise as those people go back to drug and alcohol use and resort to crime to support their addictions. This in turn will drive up the costs tremendously for society in terms of criminal justice costs.

The Republicans think they are saving money by cutting funding for Medicaid and Medicare. When the 14 to 20 million people who lose their benefits start having to get their care in emergency rooms and in hospitals, we will see the costs of health care skyrocket. Without access to primary, wellness and preventive care, people will only go to the emergency room and hospitals with serious and advanced conditions which will cost hundreds of times more than what we are paying now. Trauma, infectious diseases and substance addictions will skyrocket again and all-cause mortality will increase making the U.S. even worse compared to other developed countries in mortality rates. Uncontrolled chronic diabetes and other uncontrolled chronic diseases will cause an increase in the need to put patients on dialysis and other very costly high intensity, high tech and long-term treatments.

So far, I’ve only discussed the long-term economic consequences of the Republicans’ short-sighted and misguided bill, without considering the moral costs and consequences of the bill.

Cutting Medicaid for people struggling with addiction and mental disorders is just another form of genocide as Hispanics, Blacks and Native Americans are disproportionately affected, which is profoundly ironic as our president sanctimoniously attempts to lecture the South African president on nonexistent “white Genocide.” These cuts would be devastating to our state, where at least 90% of the people receiving care for addiction and mental health care are on Medicaid and where the majority of them are Hispanic, Black and Native American.