I may do something in November that I haven’t done since 1979. Back then I was a college student and newly registered voter. A man named William Winter was running for governor. I believed Mr. Winter was a fine man who loved Mississippi and would create state policy in the best interest of all Mississippians and not in his own best interests. I’ve voted Republican ever since. I believe a less-government, low-tax environment is always the best way to promote prosperity here in our state.

I’m an OB/GYN specialist practicing in a small town in Southwest Mississippi. My partner and I started our business over 30 years ago and have loved working and raising our families in a community of about 14,000 people. Our patient mix among our obstetric patients is about 70 percent Medicaid to private insurance. We work a little harder than our big city colleagues but we’ve felt like the lower cost of living and easy going lifestyle more than made up for the difference in pay.

Back a year or so ago the Mississippi Hospital Association was concerned about rural health care here in our state. Most of the small hospitals in Mississippi were struggling with budgets that were heavily weighted and dependent on Medicare and Medicaid reimbursement. Medicaid is the federal program that is designed to provide health insurance to low income Mississippians. It is funded by state monies that are then matched 4 to 1 by federal money. The program is administered by private companies such as United Health Care, Magnolia, and Molina. They administer the Medicaid program and are paid a fee by the state.

Over the past several years, getting paid through these entities has become more difficult and more difficult for private practitioners like us and for rural hospitals. These companies will often delay payments and deny legitimate charges by physicians and hospitals for months at a time. Trying to get through the administrative hoops to get claims paid has become a bureaucratic nightmare. Additional staff has to been hired by providers and hospitals just to try to get paid for services provided to patients because of the ongoing problems with these Medicaid administrators.

About three years ago the MHA (Mississippi Hospital Administration) invested several million dollars and came up with a Medicaid administrative product in competition with the United Health Cares and Magnolias of the world. The MHA plan would have saved the state money in administrative costs while at the same time paying claims more efficiently and at a  slightly higher reimbursement rate for health care providers and hospitals. It would have been a win for the state in lower administrative costs, a win for providers in better reimbursement and easing of billing difficulties, and a win for patients due to the probability that more providers would likely be willing to take Medicaid if there were better reimbursement and fewer administrative problems.

The bill that would have allowed this new product to be tried as a pilot program in several counties never got out of committee. It never got out of committee because the lieutenant governor would not let it out.  This made no sense to me as a conservative, free market competition guy.

Why would a new and more efficient way of delivering healthcare to rural Mississippi never even be given an opportunity? This was not Medicaid expansion. It was Medicaid reform. The only reason that seemed apparent to me was that United Health Care and Magnolia had contributed heavily to the present lieutenant governor. He controls what legislation flows through the legislature and that bill was killed because the lieutenant governor was influenced by these companies under contract with the state. It appears that Mr. Reeves either doesn’t understand rural healthcare or he doesn’t care.

My dad was maybe the most conservative guy I ever knew. He was a Fordice guy before anyone even knew who Kirk Fordice was. He taught me that true conservatism was about free markets, competition, efficiency and getting by with as little government as possible. He also taught me that another real enemy of conservatism was someone who calls himself a conservative but in reality is a crony capitalist. That is someone who talks conservatism but in reality is about themselves and what is best for them and their cronies.

So, will I vote for a Jim Hood in November? I haven’t decided yet. I need to hear more about his policies. He has his own “influence” issues of the past.  However, if he is truly conservative on social issues and moderate on fiscal issues, I will probably cast my first Democratic vote in 40 years. That’s because the way I see it, there is no difference between a liberal democrat and a crony capitalist. They’re both bad for Mississippi.

Dr. Steve Mills is an OB-GYN practicing at Brookhaven OB-GYN Associates, P.A.