OXFORD — A telecommunications company’s venture into home health care brings to mind a day when physicians made house calls and there was no Medicare or Medicaid to pay for it.

It also is a reminder that too many working poor people in Mississippi are without the means to pay for adequate medical care.

So far the Republican-dominated Legislature, as well as Gov. Phil Bryant and Lt. Gov. Tate Reeves, have thwarted any effort to expand Medicaid to working families earning below a certain amount, as provided by the Affordable Care Act. It has cost Mississippi millions of dollars in economic benefits, not to mention the human toll on individuals and families without the means to pay for all the health care they need.

Reeves successfully won the governor’s race against opponents who advocated some kind of Medicaid expansion in both the Republican primary and the general election, and he has made no indication he’s softening on the issue.

However, Secretary of State Delbert Hosemann, a Republican who was elected lieutenant governor, takes a more moderate view on the subject. Maybe there are some reforms in the future, but that’s a story for next year.

Meanwhile, there are some innovations and efforts to improve access to medical care in the state for those who do have the means, Medicaid or otherwise, to pay for it.

One is a program announced a few months back by C Spire, a Mississippi-based diversified telecommunications and technology services company, and the University of Mississippi Medical Center. They are partnering to offer visits with nurse practitioners via smart- phone for the treatment of 20 common ailments, such as colds, the flu, sore throats and insect bites.

C Spire Chairman and CEO Hu Meena, in a recent newspaper column, wrote that once consumers download the C Spire telehealth app and register for service, they will be able to make an appointment and connect via their smartphones for live video sessions with a licensed UMMC nurse practitioner.

The nurse practitioner can visually evaluate, diagnose and prescribe treatment unless the diagnosis indicates a more serious condition, in which case the individual is directed to a physician or emergency room.

Video appointments cost $59 a visit, payable online by credit card.

As Meena notes, telehealth can be especially beneficial to the poor and elderly in rural and underserved areas, who may be miles away from a doctor or emergency room.

You’ve got to be an early baby boomer, or a “Silent Generation” person like me, to recall when physicians regularly made house calls like you now see only in movies set in the 19th and first half of the 20th century.

I don’t recall the exact year, but it was some time after World War II when my younger brother and I both had pneumonia. He caught it first, and a couple of days later I had it, too.

We lived about 10 miles from town, but Dr. Harry Fridge of Hattiesburg came to our home, diagnosed us and prescribed treatment, which was administered by our mother, who was a registered nurse. Turned out I was allergic to the penicillin and broke out in a rash, requiring a change in treatment. Dr. Fridge made several follow-up visits.

Even then the in-home doctor visits were phasing out. I don’t know how many Dr. Fridge was making 10 miles from his office. The fact that he and my father went to high school together, or that he was invited to quail hunt on our property, may have had something to do with it.

Less than two decades later, in 1965, when Lyndon Johnson was president, Congress enacted Medicare to provide health insurance to people age 65 and older, regardless of income or medical history, and Medicaid for the poor.

I recall being at a McComb Rotary Club meeting around that time, and a representative of the Social Security Administration was giving a program explaining Medicare.

A physician in the audience, who obviously was against it, questioned him on how it would affect house calls.

“How many doctors make house calls anymore?” was his response to a bit of laughter.

Not many then and few to none now — unless it is an LPN by smartphone.

Charles M. Dunagin is the retired editor and publisher of the Enterprise-Journal in McComb. He lives in Oxford.

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