I’ve spent a lot of time managing restaurants in both rural and urban areas in Missouri. Restaurant employees come in all types. They include high school kids, college kids, seniors and immigrants. In the past, most of the older full-time workers were either retired, between jobs, or moonlighting. Now, with the faltering economy, there’s another group that seems to be taking over: that of the working poor.
A lot of the time they come in two’s. Not only are a lot of the immigrants, Hispanic mostly, that used to be migrant farm workers, now working in restaurants instead of the fields, but there are a lot of married couples that both have to work for minimum wage just to get by. I had one couple who literally lived on the parking lot. They lived out of their van, the two of them and a small dog.
We were close to a truck stop and that’s where they went to take showers. They ate most of their meals in the restaurant. And it was sort of like it was back in the Dust Bowl days. They heard of a restaurant in the next town that was supposedly paying a little more so they quit, loaded up the van and went on down the road.
These minimum wage workers usually don’t have any health insurance at all. If they get sick they show up at the local emergency room for treatment. A lot of them have children and end up on Medicaid. I guess Medicaid takes care of their basic urgent care needs, (that’s IF you can find a doctor who accepts it nowadays), but most of the time preventive health care doesn’t even play into the picture.
Let’s put it this way. The lifestyles of most of these workers couldn’t exactly be considered “healthy.” Rarely do they get enough exercise. Would you want to go to the gym after spending 12 hours sweating over a hot grill? Their diet consists of fat and sugar-laden fast food, or on their days off they might treat themselves to a heaping plate of Ramon noodles. Most of them drink alcohol and some use drugs. And most of them smoke cigarettes. Dental care is non-existent.
There has been much debate lately here in Missouri about Medicaid. Who should be eligible and what services should it cover? The administration under former Republican Governor Blunt severely cut Medicaid benefits to those who work. Some of those benefits have been restored, but now the debate has centered on what should be covered.
According to the St. Louis Post Dispatch, (www.stltoday.com), health care advocates have been urging the new legislature to add programs to Medicaid to help people who want to quit smoking. They say that not only can this help reduce costs in the long run, but it may also add revenue to the state budgets.
Missouri is one of only six states that don’t cover tobacco cessation programs for people on Medicaid. One-third of adults on Medicaid in the state smoke. That cost the state $532 million in health care costs related to smoking, according to the Centers for Disease Control’s latest estimates.
Last year state Medicaid officials asked for $20.8 million for stop smoking programs and counseling. It was rejected by Governor Jay Nixon, who wants to help more people get Medicaid first before adding extra coverage to the already $6 billion program.