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Montana Editorial Roundup

February 6, 2019

Billings Gazette, Feb. 4, on it being time for Montana to pay full cost to protect firefighters:

Hop onto a search engine and use the words “firefighter workers compensation” and dozens of lawyers’ websites will pop up.

It appears there’s a cottage industry for lawyers willing to fight for firefighters trying to get coverage for illnesses and ailments related to their work, including back injuries, cancer and emphysema.

In some states, firefighters who get injured by fighting fire are exempted from workers compensation. The rationale says that being a firefighter is inherently dangerous and risky. In many states, Montana currently included, the onus is on the firefighter to prove that a disease or condition was a result of battling fires. Proving that firefighting gives any person, say, lung cancer, may be difficult. After all, people who don’t fight fires can get the disease, so proving it can be hard.

Yet a state like Montana desperately needs firefighters. Sadly, with the rise of near-catastrophic wildfires, we need more and more fighters all the time. And just because we have infrared monitors and more sophisticated tools to fight fire, when it gets to the literal boots-on-the-ground phase of battling blazes, it still means coming face to face with fire and toxic smoke.

If climate change continues, we’ve been told to prepare for even more fires and more intense fires. That means the state and local communities will need more help. The least the state should be able to do is make sure that if those firefighters are in harm’s way that we take care of them into the future. We have plans to protect law enforcement officers injured on the job. We have an entire system to help veterans who suffer as they sacrifice themselves for our country: Why do we treat firefighters differently?

Sen. Nate McConnell, D-Missoula, is carrying the Firefighter Protection Act, and it shifts the burden of proof for the illness from the patient (read: firefighter) to the insurer.

Opponents of the bill worry that by adding this provision, workers’ comp rates rise rapidly. However, after similar legislation was passed in Idaho, the Gem state actually saw a decrease in rates, according to a story by Michael Woodel of the Helena Independent Record.

State Sen. Fred Thomas, R-Stevensville, carried a bill, Senate Bill 29, which would require the coverage. It has already cleared the Senate. It would require all volunteer firefighters to be covered by 2022. While McConnell’s bill looks to be more comprehensive, we also believe that Thomas’ bill is another step toward making sure we protect those who put their life on the line, even if it only covers volunteers.

It’s also worth noting that many firefighters around the state are already covered by insurance provided to them by their employers or by the city or counties. In other words, it’s not like this creates an unreasonable burden on every agency in the state. Rather, it helps equalize the playing field between those firefighters who have protection and those who do not.

It’s sad to think that even when firefighters perform heroically and stop wildfires that those same fires could still prove to be deadly.

What’s even worse is the idea that no one will be there to help if it happens.

Editorial: https://bit.ly/2RJEM8z

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Bozeman Daily Chronicle, Feb. 3, on Medicaid expansion paying dividends for state:

Republican lawmakers debating the future of Montana’s Medicaid expansion in Helena need to take their eyes off the trees and take a look at the forest.

As the federal contribution to the expansion wanes and the state’s share rises, an opening gambit on the issue from Rep. Ed Buttrey, R-Great Falls, includes raising premiums for beneficiaries and taxing those premiums, as well as taxing health care services generated by the expansion.

That clashes with Gov. Steve Bullock’s proposal that maintains the current program.

The apparent goal of Buttrey’s proposal is to get enough money out of the beneficiaries of the expansion — the insured and health care services — to cover the increasing costs to the state as federal funding for the expansion decreases from 100 percent to 90 percent. That’s an understandable goal, but it ignores many of the benefits the state has already accrued from the expansion.

A recent study by a pair of University of Montana researchers found that the expansion generates some $600 million annually for the state economy. It has created more than 6,000 jobs and $350 million to $385 million in personal income a year. All of that produces substantial new income tax collections for the state.

And much of the increase in jobs and income come in critical clinics and health care providers in rural areas that would likely struggle to remain viable without the expansion.

According to the governor’s office, the expansion is also benefiting 18,000 businesses in the state that have employees covered by the expansion, clearly a massive boon to Montana’s economy.

Most importantly, the expansion has provided health coverage for nearly 100,000 Montanans, meaning they get regular care and no longer depend on emergency rooms for primary care — care many cannot pay for, passing the costs on to private insurers and their clients. Those costs have been halved by the expansion, according to the study.

All lawmakers, conservative and liberal alike, owe it to their constituents to spend state tax dollars wisely. But numbers don’t lie. There is compelling evidence the Medicaid expansion is paying for itself and will continue to do so.

There will be a lot of give and take as the debate continues, but let’s not let counting pennies obscure the view of the big bucks the state is reaping from the Medicaid expansion.

Editorial: https://bit.ly/2HQUmzo

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Missoulian, Jan. 31, on Missoula’s fight against the opioid epidemic:

As of this month, the city of Missoula, Missoula County and the state of Montana are now each — separately — involved in legal action against drug manufacturers in response to the opioid epidemic.

Indeed, the makers of OxyContin and other powerful painkillers are facing lawsuits from communities across the nation, including Montana, alleging that they pushed opioid sales while minimizing the risk of addiction and death from overdose.

In December 2017, Montana Attorney General Tim Fox filed suit against Purdue Pharma in Montana District Court. Purdue sought to move the case to federal court, where hundreds of similar cases have been filed, but it was returned to the District Court in Lewis and Clark County last year.

Purdue has denied any wrongdoing, noting that its medications are approved by the U.S. Food and Drug Administration. However, it also has paid millions to resolve lawsuits and settlements with more than 26 other states so far. While Montana’s suit wends its way through the courts, Fox has requested a preliminary injunction barring Purdue from marketing its products in Montana.

In the meantime, Missoula County also took up legal action, filing a suit in U.S. District Court that names some two dozen pharmaceutical companies as defendants. The county began exploring the possibility of litigation last fall, entering into a contract with a Seattle law firm that also is representing local governments in other states that are suing opioid manufacturers and distributors.

The city formally entered a similar agreement with a local law firm just this month, after councilors voted to proceed with litigation. Missoula will be piggybacking on a suit filed in U.S. District Court by the city of Great Falls and Anaconda-Deer Lodge and Lake counties against nearly a dozen pharmaceutical companies.

These lawsuits all attempt to quantify the community costs of opioid abuse, from the number of deaths to the rise in crime and increased burden on health and social services. In a nutshell, the suits allege that drugmakers and markets encouraged physicians to prescribe opioids and provided inflated assurances that they are safe when in fact they are highly addictive and dangerous.

In a memo to city council members, Mayor John Engen’s Office compared the opioid lawsuits to tobacco settlements, noting, “Tobacco settlement money went to the State of Montana and was not proportionally allocated to communities based on local costs and impact.

“We believe that by joining plaintiffs through class action as a municipality, we stand to see direct benefit of settlement.”

The tactic of pursuing action separately also means that the city, county and state each negotiate their own method of paying legal fees. Missoula County signed a tiered agreement in which attorneys collect 20 percent of the total award if it is $10 million or less. The city agreed to pay up to 25 percent of any money received, plus associated attorney fees. Neither will pay any money up front, and if no money is awarded by the court, the attorneys will not collect anything either.

However, there’s good reason to believe the lawsuits will ultimately succeed in forcing the makers and marketers of powerful prescription painkillers to recognize the lasting damage linked directly to their products. Unfortunately, there’s no telling how long this process will take, or how much money Montana communities may stand to recover.

In the meantime, we must not sit back and wait for a cash infusion from drug companies to fund critical treatment services for people with addictions. Missoula must find the will and a way to provide local treatment for substance abuse, regardless of whether the substance is a prescription drug, meth or alcohol.

Missoula County counted 41 drug overdose deaths between 2014 and 2016, according to the County Health Rankings & Roadmaps compiled by the Robert Wood Johnson Foundation. This actually represented a slight decrease from the 47 fatal drug overdoses in Missoula County from 2013-2015, so the trend appears to be heading in the right direction.

Under Medicaid expansion, in place since 2015, Montana’s Department of Public Health and Human Services has provided outpatient treatment to more than 5,300 Montanans struggling with addiction. Another 1,600 or so have received residential treatment.

As Montana’s legislators wrestle with whether to renew Medicaid expansion, they ought to keep these numbers in mind — as well as the costs borne by communities now fighting back against the opioid epidemic.

Editorial: https://bit.ly/2DnMGiT

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