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Not ready for prime time

SoVaNow.com / April 02, 2014
If Frank Ruff actually had a day job, I’d advise him to stick to that rather than try his hand as a columnist. Not that I feel like I have some kind of monopoly over the craft, but just as the Supreme Court justice once was called upon to decide what is and what isn’t pornography, I know bad when I see it.

State Sen. Ruff has submitted a legislative update for today’s Sun that’s a classic of the genre. Like an Ed Wood movie, or a painting of dogs sitting around a card table, Ruff’s column can’t help but to elicit a laugh. So I suppose we should thank him for that.

It’s all about Obamacare — actually, it’s about the imagined version of the law that has taken root in the collective lizard brain of its opponents. There are aspects of the Affordable Care Act that deserve some pushback, and there are aspects that need improvement. Yet Ruff, a career politician, seems oddly incapable of coming up with actual valid examples of how the law manages to go awry.

Instead we get howlers like this:

Currently many healthcare providers in rural areas are seeing as many patients as they can schedule. Medicaid reimburses those providers less than insured patients [sic] and less than Medicare patients. Promising those going on Medicaid free service does not assure them [sic] that they will be able to see a provider. What is being done to address this issue as we move forward?

Hmm. Let’s see if I’ve got this straight: medical providers in the region see a lot of patients. Check; along with this sage observation by our senator, one should bear in mind that Southside Virginia is among the least healthy regions of the state. (Maybe Frank Ruff has some thoughts on what can be done about this.) The most important mechanism in the new law for making sure that low-income people receive decent health care is the expansion of the Medicaid program; this is the issue that Sen. Ruff is referring to in his column, and it’s the sticking point that has held up passage of Virginia’s budget. (Most Republicans are opposed to incorporating Medicaid expansion in the budget, Democrats support it, you probably already know the rest.)

Strolling further down the windy path of Sen. Ruff’s logic, it’s certainly true that Medicaid, a shared state-federal program to provide health care to the poor and disabled, generally pays providers less than Medicare, the federal health insurance program for the elderly. (A separate part of Medicaid foots the bill for most long-term nursing home care in our area.) It’s also true that some doctors won’t treat Medicaid patients due to the program’s relatively low reimbursements. So for Sen. Ruff up to this point, it’s all good.

Alas, the rest of his story holds together about as well as a wet paper bag in a windstorm. Medicaid is accepted at every hospital in the region (including Community Memorial in South Hill and Halifax Regional in South Boston), and a decent number of clinics and physician practices also do, in fact, participate in the program, meaning that Medicaid patients who need to make a trip to the doctor’s office will always have a decent set of options to choose from. By the way, medical practices in search of new patients have been known to advertise in this newspaper. A lot.

Hospitals are in an especially interesting position here. Because of a law signed by conservative icon Ronald Reagan, emergency rooms are legally bound to treat patients whether they can pay the bill for services rendered or not. So for hospitals, the choice is receiving payment through Medicaid or receiving no payment at all. (The PATHS clinic in Boydton is in a similar spot.) In suggesting that Obamacare’s Medicaid expansion places an undue burden on providers, Ruff evidently neglected to seek out the views of providers themselves on this topic. Support for Medicaid expansion among hospitals is universal — they want it, yesterday, and have said so time and again. Is it possible that our state senator could be ignorant of this essential fact?

But here’s the part of Ruff’s column I love the most: “Currently many healthcare providers in rural areas are seeing as many patients as they can schedule …. What is being done to address this issue as we move forward?” Oh no! What will happen if health care providers encounter a wave of new patients who are covered by Medicaid? The same program that pays 30 percent of the bills at the Halifax Regional Hospital ER? Will these clinics and providers be forced to hang “Going Out Of Business” signs on their doors? Or will they simply hire more employees to deal with the uptick in demand?

You don’t need to be an economics professor to figure out the answer to that question. Frank Ruff is the type of politician who probably thinks requiring financial literacy classes in high school is a good way to win votes. He should considering enrolling in one. Most businesses would celebrate seeing a steady stream of new customers come through the door. Our senator seems to think this is a problem. It’s no wonder Southside Virginia has such a persistently high level of unemployment with such deep thinkers as Frank Ruff calling the shots in Richmond.

There’s widespread consensus that Medicaid expansion will create somewhere between 20,000 and 30,000 jobs in Virginia’s health care sector. Who knows, quite a few of these jobs might end up in Southside Virginia if only Frank Ruff and his fellow travelers in the House of Delegates would relent in their efforts to block the program. (Sen. Ruff ought to be glad that I take the time to read his column. Because Democrats control the state Senate and have the votes to do what they want, no one in Richmond particularly has to care what Ruff has to say about this subject or any other. It’s the outlook in the Republican-run House that matters.) I mean, think about it: the federal government is offering to return some $1.7 billion annually to Virginia to pay for Medicaid expansion. This is money that taxpayers are already paying under the Affordable Care Act, and the only question is whether Virginia will reclaim these funds for its own use. Nothing is gained by rejecting the money; it will simply go somewhere else, and the Commonwealth will forfeit the opportunity to create jobs for nurses, lab technicians, physical therapists, physicians and other health care professionals and staff whose services are so sorely needed in our medically-underserved area.

Capping the absurdity of his column, Sen. Ruff tries for a style that’s harder to pull off than it looks: the voice of folksy wisdom. Witness Ruff’s opening paragraph, in which imagines a TV commercial that offers a deal to people whose “last names start with A through M.” There hasn’t been a commercial like that in the history of ever. Yet it’s one thing to flub matters of tone, quite another to offer up an argument that’s rank nonsense while pretending it’s the height of commonsense. Since when did it become sensible to turn down money that has been set aside for Virginia’s use, that will create jobs, and that will help low-income folks in Southside — there are lots of them, and yes, many of them work for a living — obtain decent health care?

Just remember, the Frank Ruff who inveighs against the dangers of government-provided health care is the same Frank Ruff who gets his health insurance coverage through state government, his sole (albeit part-time) employer going on three decades now. This is also the man who has traveled to France and England three times in the past four years on the public’s dime, ostensibly to recruit European businesses to Southside. Europe is the veritable capital of government-run healthcare (which Obamacare isn’t, by the way.) What are the chances that a Parisian CEO will be impressed by the business acumen of the sort that Ruff displays in his column?

If you really want to get all folksy about it, here’s a further idea for improving life in Southside Virginia: next time Frank Ruff wants to spend public funds to take a trip to Europe, make sure it’s on a one-way ticket. God save the Queen, the Commonwealth, and the good people of Southside Virginia.

***

Monday in South Hill, representatives with Tesla Motors — the brainchild of Silicon Valley inventor and ubergeek Elon Musk — scouted locations for a charging station for the Tesla Model S, an all-electric car that goes 0 to 60 in an exceedingly swift 3.7 seconds. Because Susan Kyte, our reporter, gets to have all the fun around this place, she hitched a ride in the vehicle, which retails for around $90,000, and can run $200,000 with all the bells and whistles. A boy can dream.

Whether the Tesla Roadster represents the automotive future, or is destined to serve as a prop in the reboot of the Back To The Future movies, is anyone’s guess. If history is any guide, Tesla should encourage more widespread adoption of electric motor technology, to the point where the grandkids zip around in their solar-powered cars and the internal combustion engine becomes a curiosity at classic car shows. For that to happen, of course, Tesla or others will need to develop a national network of charging stations. It’s exceedingly cool that South Hill could be in on that effort at ground zero.

Next up for Tesla: mollifying the muscle car crowd with some loud vroomy noise to go with all that speed. One side or another is gonna have to give ….











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