OK

I have a few questions for the governor of Kansas who is refusing to expand Medicare. I expressed those questions in the LTTE below the orange squiggle to the Topeka capital Journal, here in Topeka.

The editor wants me to pare it down from its current 523 words to just 350 words. I've written many letters to the editor and had my share printed. But they were all opinion, and this one is based on facts. The opinion editor wants to run it, but it is too long for him to do so. I'm worried it will lose something if I just start whittling away. When writing such letters, does one need to cite sources verbatim or is paraphrasing enough? Can I get a critique and some suggestions from the experts here? Feel free to let 'er rip, I have big shoulders and even though I'm a Marine who hasn't been deployed for 36 years, I can take your best and worst! I will check in later this evening and hope for the best!

I have been watching the healthcare debate rage back and forth in the media since Hillary Clinton chaired her infamous committee almost twenty years ago. It was and remains my opinion that everyone deserves adequate healthcare. Further, it was my opinion the hospital industry as well as the insurance industry were against any reasonable inroads made into their monopolies. In other words, the game is rigged just as it always is. It is rigged by having little oversight of costs by states or the federal government against all who are living paycheck to paycheck.
I know our esteemed Governor wants nothing to do with an expansion of Medicare, as do another 20 or so states. In fact, I recall the governor rejecting money that would have set up the computer system the Insurance Commissioner’s office needed to expand and implement the ACA. So imagine my bewilderment when I read in the Washington Post that the American Hospital Association, the Federation of American Hospitals and the Catholic Health Association had reached an agreement with the administration to “contribute $155 billion over 10 years toward the cost of insuring the 47 million Americans without health coverage, according to two industry sources.”  I wondered how that was going to happen with little more than half the states actively expanding Medicare. Then I read that Obama’s administration had identified $200 billion in cuts over the next 10 years and that brought the associations to the bargaining table where the deal was struck July 3rd. According to the industry, because the reductions in Medicare are going to happen independently of what the states do, they want all of the states to take the deal.
In fact, the Huffington Post has a story that dealt with the impact those cuts will have in just two states, Florida and Texas.  The author of the blog says, “Hospitals that currently treat the poor for free in emergency rooms were counting on a broad expansion of health insurance coverage to cut down on the number of unpaid bills on their books. The American Hospital Association and other national industry groups endorsed the health care reform law, calculating that more insured people would make up for $155 billion in lower Medicare payments over a decade.”
The author continues, “A smaller Medicaid expansion would be bad news for hospitals, especially in states like Florida and Texas with large numbers of uninsured people, according to Sheryl Skolnick, a health care equities analyst at CRT Capital Group in Stamford, Conn. "That risk is real and meaningful: the hospitals may end up paying for the poorest and sickest of today's uninsured anyway AND see cuts in Medicare and Medicaid on top of that," she wrote in a note to clients Friday.”
The $155 billion is the exact amount they agreed to on July 3. So I am left with a few questions that I’d like someone to address: If Kansas does not expand Medicare, how do our hospitals make up that difference? Along the same reasoning, how badly will this hurt our already struggling rural hospitals where the number of poor patients has already strained their budgets?

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