Morton Comprehensive Health Services Inc. has been providing quality health care to Tulsa’s minority, indigent and vulnerable citizens for more than 90 years.
But now it’s in trouble.
The state’s uncompensated care fund, a traditional source of funding for Morton, is getting split up by more community health centers and cut by the Legislature. Meanwhile, the state’s decision not to accept federal funding for Medicaid expansion means many of Morton’s clients are too poor for “Obamacare” subsidies and too rich for Medicaid.
Long story short, the largest community health center system in northeastern Oklahoma is running out of money ... but it’s not running out of sick people.
As a result, CEO John Silva announced that as of Jan. 5 Morton’s six-clinic system, which annually serves 22,000 patients from 221 ZIP codes in 16 counties, would stop accepting new uninsured clients. Roughly 58 percent of Morton’s clients are uninsured. Until that number gets down to 45 percent, Morton will turn people away.
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Morton is not alone in this situation. Similar clinic systems throughout the state are facing the same financial problems caused by the same health policy decisions. They will face similar bad choices.
It’s good accounting, but bad for the sick people those clinics serve.
It’s also bad for other people, middle-class people, newspaper readers.
Here are eight reasons why you should care:
1. Emergency rooms: Based on figures Morton gave me and some back-of-the-envelope math, I figure the no-new-uninsured clients decision will mean about 500 patients won’t be treated at Morton this year. That doesn’t mean they won’t be treated. The next stop for many of them will be a hospital emergency room, where people in need of treatment can’t be turned away. Were you relying on that emergency room the next time you have a traffic accident? How much longer are you willing to sit in the waiting room?
2. Insurance costs: Those patients going to hospital emergency rooms won’t have insurance or money in their wallets to pay for treatment. The hospitals will try to shift costs to their insured clients. Were you budgeting for a premium increase next year?
3. Rural hospitals: Similar processes are happening at community health centers all over the state. The hospitals won’t be able to recover all of the cost they lose as a result. Along with the patients, the financial troubles will shift from the health centers to the hospitals. While I’m not worried about the financial stability of Tulsa’s big medical centers, some of the rural hospitals are on much shakier ground. Were you counting on there being a hospital in the towns you drove through the next time you left Tulsa?
4. Work force: The vast majority of Morton’s clients are employed. If Oklahoma’s work force is sick, it doesn’t work. It isn’t productive. The state is less attractive to new businesses. Were you hoping for some economic growth in Oklahoma’s future?
5. Public assistance: Sick people who can’t work end up relying on other government assistance programs. Would you rather Morton’s clients were taxpayers or tax consumers?
6. Public health: Every once in a while, Morton diagnoses a patient with tuberculosis or flu or, maybe, measles. Do you want those patients getting treatment at Morton or sitting next to you, coughing?
7. Safety net: The fall from the middle class is not a long one, and it can happen very quickly. Do you want there to be a primary care safety net available if you lose your job?
8. Morality: I’m not convinced that health care is a right, but it is the right thing for society to do. We’re the richest nation on Earth and sit at the apex of centuries of medical science advances. What does it say about our culture if we allow the poorest members of society to suffer from treatable diseases?
This can be fixed.
If the state accepted federal Medicaid funding, most of the problems at Morton (and a lot of the problems at hospitals too) would go away.
On a politically more realistic level, if the state would just adequately fund its uncompensated care fund, we could stabilize the finances of the clinic systems.
In fiscal 2014, the state appropriated $3.2 million to the fund, and all of the money was spent well before the year ran out. In fiscal 2015, the funding was cut to $2.02 million, which was supplemented with $400,000 from the state health department.
Those numbers are going the wrong way. For a relative pittance, perhaps $10 million in a state budget that will be close to $7 billion, Oklahoma could shore up an important health network that protects public health, work force stability and the entire health care system. And everyone should care about those things.






