Opinion -- The Reagan Edict: Trust, but Verify

Adam Crumbliss, Director of Community and Public Health at the Missouri Department of Health and Senior Services

I grew up in the heart of Missouri Republicanism. I've clung to the common sense values of my hometown of Joplin. These values are best articulated by the President of my youth, Ronald Reagan. "The most terrifying words in the English language are: I'm from the government and I'm here to help."

Fast forward several years. I spent 20 years of my career working for the Republican-controlled statehouse before moving to the Missouri Department of Health and Senior Services. I've never lost my Show Me skepticism, and my work is guided by another Reagan quote, "Government's first duty is to protect the people, not run their lives."

The political left is wrong to believe that government can 'solve COVID,' while the political right is wrong to suggest nonsense conspiracy theories that COVID isn't real or vaccines cause it.

More than 638,000 Americans have died from COVID. That is nearly the same number of American combat deaths in the American Civil War, World War I, World War II, the Korean War, the Iraq War, and the Afghanistan War combined.

In the COVID battle, Reagan's maxim says it all for me:  "We can't help everyone, but everyone can help someone."

Last year, I was blasted by a city newspaper for allegedly downplaying COVID in a social media post I wrote when Missouri had 8 COVID deaths. Ironically, the post said, 'I'm not down playing the impact of COVID. To the contrary, it's a stark reminder about our fears that it is outside of our span of our control.'

Fear is a powerful motivator. Be skeptical of those in and out of government that try to scare you into getting a vaccine. But, I hope to appeal to your better angels and suggest getting it.

As a leader of Missouri's team responsible for coordinating public response and vaccine efforts, we have been careful to not support fear-mongering or catering to the lowest common denominator.

I do believe data that shows the current Delta variant deluge in Missouri is real, is twice as infectious as last year, and is more likely to impact children and the unvaccinated. I keep a Reagan-Bush campaign button that says, 'the time is now," and on COVID vaccines I certainly believe that.

Reagan was right. Government isn't the solution. The American people are.

For those skeptical or opposed to the vaccine, only be so because of facts and avoid nonsense. When was the last time your auto mechanic gave you golden financial advice? Stop listening to conspiracy theorists and pundits.

Talk to your doctor. If you don't have one, find one that is a straight shooter with good character. Make an informed decision that is best for you and your loved ones.

For those that want others to get the vaccine, don't pester, condescend, and belittle. These are our brothers and sisters, neighbors, church family, and friends.

In the end, government won't solve this problem, but as Reagan said, everyone can help someone.

Missouri to Implement Medicaid Expansion

In accordance with the Cole County Circuit Court's August 10 ruling, the Missouri Department of Social Services (DSS) will begin allowing individuals to apply for the MO HealthNet program under Article IV, Section 36(c) of the Missouri Constitution.

"My administration is always going to follow the law and yesterday's court order is no exception," Governor Mike Parson said. "The necessary funding to cover the health care costs of the expanded population remains the issue. We will continue to work with the General Assembly and DSS to chart a path forward to comply with the court order and keep the MO HealthNet program solvent." 

Missouri voters approved Medicaid expansion, the Supreme Court of Missouri held the expansion amendment to be constitutional, and the trial court has ordered the state not to prohibit enrollment. The expansion amendment also legally requires the state to maximize federal funding. DSS will continue to work towards fulfilling the state's legal obligations under the Constitution and court order. 

The state is currently working through administrative hurdles, including adequate appropriations, staffing capacity, and computer software changes in order to begin enrolling the expanded population. Governor Parson included funding in his FY 22-23 budget proposal to the General Assembly to cover both the health care costs of the expanded population and for 75 additional employees to administer the expanded program.

The proposed funds were not included in the final FY 21-22 budget. As a result, DSS is limited to administering the expanded MO HealthNet program without sufficient staffing or appropriations. 

Missourians who believe they are eligible for MO HealthNet benefits under the expanded Medicaid eligibility may go to MyDSS.MO.Gov to apply. DSS will begin making eligibility determinations once MO HealthNet's software is updated to reflect the court order. In order to comply with the court order and until the necessary funds can be appropriated, DSS will reassign existing employees from their current assignments and responsibilities in order to receive and evaluate MO HealthNet applications.

Due to current staffing capacity and funding restraints, the required system update is anticipated to take up to 60 days. Qualifying health care costs that are incurred by eligible Missourians between the time they apply and when DSS is able to verify their eligibility may be reimbursed at a later date. 

Mike Thomson Co-Sponsors Bill that would Make Many Cold Medicines a Prescription Drug

State Representative Mike Thomson is co-sponsoring a bill that would make pseudoephedrine, a common cold medicine, a Class III drug, meaning that it would only be available through prescription with certain exceptions. That means that if people were to get a cold and they needed medicine for relief, they may have to go to the doctor's office and get a prescription in order to go to the pharmacy. Pseudoephedrine is also a key ingredient in the manufacturing of meth and the purpose of this bill is to make it more difficult for people to make meth and sell it.

The bill classifies a bunch of different drugs as schedule I drugs. Schedule I drugs include drugs that have no accepted medical value and which have a high potential for abuse. Drugs that are schedule I include such drugs as opiates, including their isomers, esters, ethers, salts, salts of isomers, esters, and ethers unless specifically excepted whenever the existence of these isomers, esters, ethers, and salts is possible within their specific chemical designation. It gives a long list of specific compounds that would be classified as schedule I.

It also classifies opium derivatives, their salts, isomers, and salts of isomers unless specifically excepted whenever the existence of these salts, isomers, and salts of isomers is possible within the specific chemical designation.

Schedule I drugs would also include materials, compounds, or preparation which contain any quantity of specified hallucinogenic substances, their salts, isomers, and salts of isomers unless specifically excepted. Marijuana is specifically included in this list of substances. There is a list of depressants and stimulants as well.

Among drugs that are placed in Schedule II, the DHSS will place substances in Schedule II if it finds that they have a high potential for abuse, but has current accepted medical use in treatment in this country or currently accepted medical use with severe restrictions and the abuse of the substance may lead to severe psychic or physical dependence.

Pseudoephedrine would be placed in Schedule III along with ephedrine and phenylpropanolamine. Schedule III would be drugs that are less severe than Schedule I or Schedule II. Dietary supplements, herbs, or natural produces including concentrates or extracts that are not otherwise prohibited by law and that contain naturally occurring ephedrine alkaloids in a matrix of organic materials such that they do not weigh more than 15% of the total weight of the product are excepted. Manufacturers can exempt by rule any product containing these cold medicines if they are formulated to effectively prevent conversion of the active ingredient into meth or its salts or precursors. However, the Missouri State Highway Patrol can find probable cause that such a product does not effectively prevent conversion of the active ingredient into meth and the DHSS can issue an emergency rule revoking the exemption for the produce pending a full hearing.