Our Weaknesses Are Laid Bare

Jeremy Jeffcoat | May 22, 2020 | Opinion Article
Pickens County Medical Center
Pickens County Medical Center is the latest Alabama hospital to close due to lack of revenue.

Our weaknesses are laid bare, Alabama. At times, there are passionate debates about what issues need to be addressed first in our state. We spend a great deal of time chasing our tails over issues like prison overcrowding, gas taxes, and toll roads…but now reality is hitting us squarely in the nose. We should, after only two months of dealing with COVID-19 disruption, have a solid handle on the issues that must be addressed if Alabama is to move forward as a state. Fortunately it is not a huge list, and with due respect to Senate Pro Tem Del Marsh (R-Anniston), a nicer office for himself and his buddies does not make the cut.

We must now face, in all honesty with ourselves, that we have a poor health care system, a lagging education system, and a general inequity in funding and access for those in the minority and low-income areas. That’s it. If we address those issues, we can be a better state and come out of the COVID-19 crisis stronger.

On health care, it has been noted many times that Alabama’s rural hospital system is struggling, due in large part to low Medicare reimbursement rates and the high volume of uninsured (roughly 300,000 in Alabama). According to a recent study at the University of North Carolina, the states with the highest rate of hospital closures in the last ten years are Texas, Tennessee, Oklahoma, Georgia, Alabama, and Mississippi. It is not a coincidence that ALL of those states are among the 13 that have yet to expand Medicaid under the Affordable Care Act. It is estimated that at least 200,000 Alabamians would gain some sort of health coverage under the expansion, meaning that hospitals, especially in poor, rural areas, would see more payment and less default.

It must be said that Medicaid expansion is not a giveaway. The people who benefit most from Medicaid expansion are low-income, WORKING people who make too much to qualify for traditional Medicaid, but too little to afford private insurance. It also must be said that expansion more than pays for itself with a 9-1 matching federal component. The initial cost of expansion is less than Sen. Marsh wanted for his new offices.

The built-in inequity of Alabama’s education funding has also been exposed more than ever. Funding for local school systems is built around the tax base of the local community. The problem with that is that the schools and students needing the most help (poor and rural communities), get the least help by the very nature of their socioeconomic status.

As we run our households and businesses, we generally try to shore up our weak points, understanding that the whole benefits when the weakest are made stronger. Alabama does not work that way in education. As a result, we see some school systems in wealthier areas that are prepared to deal with the technological challenges of this situation (the wealthier districts), and others that are not (the poorer ones). Again, this is not a Ph.D. level exercise in discernment…it is common sense that Alabama must find a path to a more equitable school funding system that allows those in struggling communities access to the funds and materials necessary to rise. Lottery funds could certainly help in that regard if they are spent wisely. But recognition of the inequities that exist, and a commitment to addressing them, must also be present…or that money will be wasted.

Both of the aforementioned issues are rooting in longstanding prejudices that continue to hold Alabama back, and they are more visible than ever in a health and economic crisis. We have yet to come to the place where we realize that many of Alabama’s citizens are not given equal access to the tools necessary to rise above their circumstances (particularly access to health care and quality education). Dr. Martin Luther King, Jr. once said that “it’s a cruel jest to say to a bootless man that he ought to lift himself by his own bootstraps.”. When the deck is stacked against our poorest citizens, in communities of perpetual poverty and struggle, none of us are able to reach our potential as a people.

When Cain killed Abel, he lied to God by claiming not to know his brother’s whereabouts…”I know not; am I my brother’s keeper?” It didn’t work out too well for Cain. We are all, in a sense, our brother’s keeper if for no other reason than we all benefit when more of our people are able to succeed. We could put into place the reforms necessary to build an Alabama where the opportunity for success is greatly enhanced…or hell, we could just build Del Marsh his nice new offices.

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Absence of Foresight
Jeremy Jeffcoat is an Alexander City resident and former candidate for Alabama House District 81.

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