Paul tells doctors and officials at Ashland hospital, a beneficiary of Medicaid expansion, that the country can't afford to keep it

Sen. Rand Paul at the hospital. (Daily Independent photo by Rachel Adkins)

The nation can't afford to continue the expansion of Medicaid, U.S. Sen. Rand Paul told doctors and officials Friday in Ashland at King's Daughters Hospital, which has benefited greatly from the expansion.

"We don't have any money; we have a printing press," said Paul, a Bowling Green eye surgeon. "And we borrow $500 billion a year. And there is the question: Could we ultimately destroy the country with that much debt? I call it the big-hearted, small-brain syndrome, which is very, very prevalent in Washington. They are sympathetic, they want to help people. We all do. But the thing is, if you destroy the country helping people, would you be better off or worse off?"

Before the Patient Protection and Affordable Care Act, Medicaid paid for "about 17 percent of patients in the King's Daughters Health System," Adam Beam reports for The Associated Press. Now that the law has added 470,000 Kentuckians to the rolls, "Medicaid pays for 23 percent of patients at the hospital system on the Kentucky-Ohio border."

The health bill sent to the Senate by the House would end the Medicaid expansion after 2020. Not having the expansion "would be the difference between staying open and not staying open," Chief Medical Officer Richard Ford told Beam.

King's Daughters' share of uninsured patients fell to 2 percent from 11 percent after Medicaid was expanded in 2014. "But despite the hospital's dependence on Medicaid, the amount of money the hospital made from each of those newly insured patients fell, too," Beam reports. "Ford says the system struggles to make a profit."

"It was more of a redistribution from one patient to the next more than it was helping us with covering our own expenses," Ford told him.

"Paul's solution to fix all of this is to make the health care system more market-based," Beam reports. "He wants to make it legal for people who don't get health insurance from their employer to join together with others in nationwide "health associations" to increase their bargaining power. Imagine, he said, if the National Rifle Association's more than 5 million members were able to join forces and negotiate with health insurance companies as a group instead of individually."

Garfield Grandison, a gastroenterologist, told Paul that he and other senators should consider more factors than cost. "Grandison and a local social worker said they’re concerned patients suffering from mental health and substance abuse problems could be hurt by the ACA replacement," because those would no longer have to be covered by health insurance, Andrew Adkins reports for the Ashland Daily Independent.

Paul said that would make premiums go down, and "said the fundamental question is based, for instance, on if a 72-year-old should be forced to pay for special procedures for others, such as pregnancy, in a free society," Adkins reports.

Grandison replied, "Should I be forced to drive on every single road my taxes pay for, or use every park my taxes help pay for? I understand from the standpoint of cost, where you’re going. You’ve made a good argument on cost, but there are other aspects that should be considered and part of the debate."