Path Home Shows 2016 Show Archive April 2016 Show 1616 Doug Cox - At Odds over Health Care Reform

Doug Cox - At Odds over Health Care Reform

Emergency room doctor Doug Cox, a Republican legislator from Grove, is at odds with his own party when it comes to our state’s approach to federal health care reform.
Doug Cox - At Odds over Health Care Reform

Doug Cox - At Odds over Health Care Reform

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Patient Protection and Affordable Care Act

OSU Center for Health Sciences

Show Details

Show 1616: Doug Cox - At Odds over Health Care Reform
Air Date: April 17, 2016



Rob McClendon: Well, legislative leaders at the state Capitol are the first to tell you that accepting anything linked to President Obama’s Affordable Care Act is probably a nonstarter with their rank and file members, but not all of them. Rep. Doug Cox is a Republican member of the House and an emergency room doctor in Grove, Oklahoma, which places Cox at odds with his own party when it comes to our state’s approach to federal health care reform.

Rob McClendon: Inside these doors at the Integris Hospital in Grove, Oklahoma, emergency room physician Doug Cox has seen it all.

Doug Cox: You know, I’ve seen a dramatic change. First of all, there’s been a huge increase in volume. Secondly, primarily we used to see emergencies, things such as strokes; heart attacks; cuts that needed to be sewn up, sutured; broken bones. It was truly an emergency room. Now, probably 90 percent of what we see in the emergency room is not a true emergency. It’s everything from a toothache to a common cold, 90 percent of which could be handled in a private physician’s office, a family medicine or an internal medicine’s office.

Rob: Why do you think that is?

Cox: Well, I think there’s two reasons. And that’s what kind of keeps me grounded. Working in the ER we deal with real life and real-life situations. And we see people in the emergency room who have a primary care physician. They’ve tried to get into that doctor’s office, but they say, well, our first opening is in three weeks. I think that’s an indication of the physician shortage in Oklahoma; it’s statewide, it’s nationwide, but it’s a little bit worse in Oklahoma than it is in most states. And it’s worse in rural areas such as Delaware County, Grove, Jay, my surrounding area. Now, one thing about the emergency room is we treat all comers. To me it’s comforting, it’s reassuring, it’s what America is about, to know that regardless of your socioeconomic status you’re going to get the same great care in this emergency room whether you’re a millionaire or a pauper. Contrary to popular belief, it is hard-working, taxpaying Oklahomans that can’t afford health care insurance. Unfortunately I see it every day here, a couple of things. No. 1, someone may come in here and they’ve gone to a physician, got treatment, got an appropriate medication, can’t afford to buy the medicine. They don’t have insurance to help them with their pharmacy bill. So it’s a tough situation.

Rob: And oftentimes may find themselves right back in here for expensive care?

Cox: That’s true, and the emergency room is the most expensive place to get care. And I may surprise you by saying this, but as an ER physician, I know it’s not the best place to get care for chronic problems such as high blood pressure, emphysema, because if you come in here 10 times you may see 10 different emergency room physicians. There’s just no continuity of care.

Rob: Oklahoma is one of 19 Republican-led states that declined to expand Medicaid under the Affordable Care Act, leaving roughly 90,000 Oklahomans uninsured that otherwise would qualify in other states.

Cox: It’s going to put a cramp in already cash-strapped, particularly rural, hospitals.

Rob: So is it fair to say that, in this instance, the rhetoric and the heat of the politics have maybe got in the way?

Cox: Well, I think so. I mean especially the argument of hey, we don’t want to take any of those nasty federal dollars. Well, look around, we took them for disaster aid, as we should have. We take them for roads and bridges. We take them for education. If you look at our state budget, a huge chunk of it is made up by federal matching dollars. Those are a return of our dollars that we as hard-working Oklahomans send to the federal government in the form of federal taxes. The program is set up for us to reap some of the benefits of those by returning to Oklahoma. And yet the political rhetoric has tended to put blinders on people when it comes to health care.

Rob McClendon: Now, it's estimated 56 percent of all emergency room visits are potentially avoidable, and that's a waste of about $38 billion annually.