Morton Marcus: Indiana on the verge of compassion


The Indiana General Assembly, which gets its share of bruises, is getting close to doing something very beneficial for a some very sick children, their parents and their siblings.

Hoosiers are fortunate to have the Riley Hospital for Children located in Indianapolis. It is nationally ranked in 10 children’s specialties. However, it is in Indianapolis. That’s not a bad thing, except if you are poor and live in a corner of the state.

Imagine your family on Medicaid. Not Medicare — which is primarily for the older population — but Medicaid, the stepchild of health care in the United States. The federal and state governments share Medicaid costs, with the states anteing up 34% of the fees paid to health care providers.

Your family is very poor; if you weren’t, you wouldn’t qualify for Medicaid. You have just one old, not-very-reliable car, and one very sick child. To get a proper diagnosis and treatment plan for that child, Indiana’s Family and Social Services Administration would have you go to Riley in Indianapolis.

But how far is Riley from the extreme reaches of the state? From Hammond (Lake County), Fremont (Steuben), Vevay (Switzerland), New Albany (Floyd) and Mt. Vernon (Posey)? In terms of distance, the average is 150 miles or 2½ hours one way. Double that to come home. Yes, 300 miles in an unreliable car and five hours on the road when there are closer alternatives in Chicago, Louisville and Cincinnati.

When there is a distinguished hospital in an adjoining state, that might be a better choice for the child, the parents and any siblings. Last year, the Indiana Senate rejected a bill that would have granted parents that choice. Why? The out-of-state hospital might expect Medicaid reimbursement from Indiana at a higher rate, as approved in their state, than Indiana would approve. We do have a reputation for being cheap.

How much money are we talking about? The Indiana Legislative Services Agency, recognizing that an exact estimate was not possible, advised “Indiana’s state share … would be between $300,000 and $950,000.”

You’ll be proud to hear the bill in the current session passed the House by a vote of 93 to 0. Now it rests with the Senate. In fiscal terms, this proposal is hardly to be noticed in a total budget of $36 billion as passed by the House.

Rep. Hal Slager of Lake County and Sen. Mike Bohacek of LaPorte County introduced House Bill 1305 to enable Hoosier families to use out-of-state hospitals to treat their children when circumstances require such action.

When passed by the Senate, this will be a major benefit to poor Hoosier families caring for extremely sick children.

Morton Marcus is an economist. You can contact him at [email protected]. You also can follow his and those of John Guy on “Who Gets What?” wherever podcasts are available.Send comments to [email protected].