As Mississippi legislators head to conference on the state’s first sincere consideration of some form of Medicaid expansion, we’ve heard alarms sounded by the right and the left on why the state alternately should or should not expand Medicaid coverage for the state’s working poor.
Proponents of Medicaid expansion celebrate the fact that Mississippi is finally taking steps toward reclaiming a portion of the federal tax dollars Mississippians have been paying to provide expanded Medicaid coverage for the working poor in 40 other states but not in our state where healthcare disparities loom large in the poorest state in the union. Opponents of the Mississippi House version of Medicaid expansion in Mississippi and the other 10 states across the country that have not expanded coverage make three primary arguments – the state can’t afford the state share of the costs, expanding Medicaid will discourage finding work, and states should not increase enrollment in a “broken program.” The political wars and the messaging generated by both sides are contradictory and confusing. But a March 2024 U.S. Department of Agriculture Economic Research Service report suggests that for rural Mississippians, the state’s Medicaid expansion debate actually might have life or death consequences. The report, entitled “The Nature of the Rural-Urban Mortality Gap,” was authored by USDA economists Kelsey L. Thomas, Elizabeth A. Dobis, and David A. McGranahan. The researchers concluded that “The 2019 age-adjusted natural-cause mortality (NCM) rate for the prime working-age population (aged 25–54) was 43 percent higher in rural areas than in urban areas. This is a shift from 25 years ago when NCM rates in urban and rural areas were similar for this age group.” More specifically, the report’s findings were: “There is a growing natural-cause mortality gap between rural and urban areas of the U.S.; Over the last 20 years, the difference between age-adjusted natural-cause mortality rates for the overall population in rural and urban areas grew from being 6 percent higher in rural areas than urban areas in 1999 to 20 percent higher in rural areas than urban areas in 2019; “The rural, prime working-age population was the only group to experience an increase in NCM rates, resulting in an even greater increase in the mortality gap between rural and urban areas. In 1999, the NCM rate for the prime working-age population in rural areas was 6 percent higher than in urban areas, growing to 43 percent higher in 2019; and the more rural the area, the greater the increase in prime working-age NCM rates (or smaller the decrease) over time.” Why does that matter? The report found that rural working-age people in the South are dying at a higher rate than their urban counterparts – and Mississippi is a rural state. According to the U.S. Health and Human Services, Mississippi is rural, where 65 (79.3%) of the 82 counties are considered rural areas. Mississippi has three standard metropolitan statistical areas (MSA): the Jackson Metropolitan Area; the Hattiesburg Area; and the Gulf Coast Region. Desoto County, located in North Mississippi, is included in the Memphis, Tennessee MSA. All 82 counties in Mississippi are designated whole or in part as medically underserved areas. Is the lack of expanded Medicaid a sole-source cause of those health disparities? Of course not. The report’s authors acknowledge high incidences of obesity, smoking, poor-quality diets, and other place-based influences on the mortality gap, along with: “Both hospital closures and physician shortages in rural areas are also a growing concern and could lead to higher rural mortality rates as well.” They likewise note: “It is plausible that differences in healthcare resources and health behaviors across urban and rural areas could contribute to the stagnation and even increasing mortality rates in rural areas, as the accessibility, quality, and affordability of care could be compromised. Healthcare resources and services vary by population density, often leaving rural areas with limited medical treatment and less accessible options that could adversely impact mortality rates.” The most germane passage in this study of rural people dying faster than urban neighbors is this one: “Regionally, differences in state implementation of Medicaid expansion under the 2010 Affordable Care Act could have increased implications for uninsured rural residents in states without expansions by potentially influencing the frequency of medical care for those at risk and preventive measures.” Sid Salter is a syndicated columnist. Contact him at sidsalter@sidsalter.com.Wednesday, April 17, 2024
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Trollfest '09
Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.
Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).
Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.
Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".
In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.
In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.
Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.
Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!
This is definitely a Beaver production.
Note: Security provided by INS.
Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).
Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.
Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".
In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.
In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.
Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.
Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!
This is definitely a Beaver production.
Note: Security provided by INS.
Trollfest '07
Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.
There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.
If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!
This is definitely a Beaver production.
Note: Security provided by INS.
There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.
If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!
This is definitely a Beaver production.
Note: Security provided by INS.
19 comments:
Did they factor in the number of couches per household? Studies show a direct correlation
Health starts with the individual. People have to make better choices. I know for a lot of MS, including the rural working class, the choices are few. I'm all for expansion of Medicaid but that alone will not improve mortality rates at all.
Sorry for the double post but I missed Sid's "life or death consequences" blurb. The availability of Medicaid doesn't change human behaviors that are detrimental to a person's health.
I wonder if the authors checked the correlation between % of the population already on government managed healthcare and morbidity.
Now even the Rs are embracing the redistribution of wealth. Will cats soon be sleeping with dogs?
Look at people who are already on Medicaid to see if we need or want more of that. Are they mostly healthy or are they mostly obese and mostly showing abysmal / poorer health than people who aren't on Medicaid?
Who expects new Medicaid recipients to somehow improve overnight , just because we have more people on the program? Not I .
For Sid's argument to hold water, you'd have to adjust for all other variables between urban and rural residents to make the case that Medicaid expansion would meaningfully affect mortality. Exercise, diet, education, income, etc. are all major variables.
He said it himself. Hospital closes and physician shortages "could lead" to higher rural mortality rates. But that's not conclusive at all.
Mississippi=obese people. How many buffets are there in the rural areas? The Chinese buffet, the Southern Style buffet, KFC chicken buffet? Let's start there...
If you are a Democrat, it’s the thought that counts. And all that counts.
What you'll never see a columnist write about is the shrinking number of tax-paying citizens and businesses while the number of those on various welfare and assistance programs are growing rapidly. Making matters worse, politicians in Washington apparently want the U.S. financial system to run to the cliff instead of walking to it - so they allow non-citizens to suck the dollars out of our system, too.
More money does not cure obesity and lethargy
To our Christian friends, I think that it was Jesus who said something to the effect of "just as you do unto the least of these, you do unto me."
@10:10
If you are a Republican, it is the lack of thinking that counts and shows.
1:05 PM,
He was talking about personal charity, not government welfare programs. The equivalent would have been overtaxing the Judaeans to give free stuff to people who didn't really earn it, while the tax collectors ended up wasting half of the money. I don't recall seeing that mentioned in the Bible.
If you believe that America is a "Christian Nation", then how can its Christians (and its Christians) justify denying something as basic as reasonable medical care to its working poor. It's my observation that if Jesus lived in America today, that many of those who claim to be Christians would look down upon him.
Saltwater pappy, how can a closed doctor's office treat patients? How can a closed hospital provide healthcare services? These facilities must operate as a business just like Walmart does or they have to close. And unlike Walmart, hospitals are required to treat a patient regardless of their ability to pay.
Ask any provider - Medicaid does not pay providers a dollar for every dollar of care provided. Instead, Medicaid pays cents on the dollar and the rest has to be written off. That's what is known as "red ink" and too much of it puts you out of business.
In areas where there is a decent number of private pay and insurance, that helps offset the losses. But in places like the Mississippi Delta where most of the patients are Medicaid, there's just no viable way for a hospital to pay overhead, salaries, etc. and stay open. Increasing the number of cases where the hospital has to trade every dollar for 35 cents is not going to help matters. It will cause hospitals to close permanently.
If you thought changing the flag would help race relations in Mississippi then you'll fall for the ruse that Medicaid expansion will save hospitals and make the obese suddenly thinner because all they needed, but couldn't afford, was an appointment with a physician to tell them they were fat and needed to lose some serious weight.
Here's your sign.
If I'm not mistaken, we're already seeing community hospitals around the state closing due to lack of revenue.
9:41--Don't forget those who won't quit smoking, abuse alcohol, and refuse to exercise.
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