Getting care in Ottawa County should not depend on how long you can wait, how far you can drive, or whether you can afford to miss work.
A parent needs a mental health appointment for a child. A worker puts off a dental visit because of the bill. Someone with a new diagnosis leaves the doctor’s office with a referral, then spends weeks trying to figure out who takes their insurance.
Michigan has programs that help. The Healthy Michigan Plan provides low-cost coverage for eligible adults, including preventive care, prescriptions, and mental health and substance use treatment. But an insurance card does not guarantee a nearby appointment or make every bill easy to understand.
Ottawa County residents have told us where the gaps are. The local community health assessment identified mental health, access to healthcare, and housing as priorities. It found that residents reporting poor mental health had doubled since the first assessment cycle. Among surveyed residents, the difficulties were especially pronounced for underserved households.
Joe Moss’s record on public health funding
In August 2023, while chairing the Ottawa County Board, Joe Moss proposed reducing the county general-fund allocation for public health to $2.5 million, compared with the department’s $6.68 million request. His own press release said the proposal would leave the department with an estimated total budget of about $9 million.
That proposal was not the final budget, and voters deserve the distinction. The board ultimately adopted $14.40 million in public health expenditures for fiscal 2024, down 5.6% from the prior year, and declined $2.2 million in proposed COVID-related grants. The county said the adopted budget funded critical programs; the question is whether reducing resources and rejecting available funds helped residents get the care they needed.
Moss framed the debate around returning spending to earlier levels. Meegan Zickus would start with a different set of measures: Can residents get an appointment? Can they understand and afford the cost? Are we catching problems early enough to avoid more expensive care later? Those are the results families experience.
Other states are testing practical answers
We do not have to pretend Ottawa County is the first place to face these problems.
Massachusetts made mental health care easier to reach. Its Community Behavioral Health Centers offer urgent mental health and substance use care, including round-the-clock crisis services, with a statewide help line that connects people to care. The useful lesson is a clearer place to start when someone needs help now. Massachusetts reports substantial use of the centers, though that alone does not prove the program saves money.
Oregon ties part of Medicaid payment to measurable care. Its coordinated care organizations can earn quality incentive payments based on published measures and improvement targets. That gives the state a way to ask what its spending is producing, rather than measuring effort by dollars spent alone.
Maryland tested a different way to pay hospitals. Its all-payer model set hospital budgets and aimed to reduce avoidable spending while maintaining quality. A federal evaluation estimated $975 million in Medicare savings over the model’s five years, alongside slower growth in total Medicare expenditures for beneficiaries. Maryland’s system is complex and cannot simply be transplanted to Michigan, but it shows that cost control can be tested and measured.
What Meegan would push for
Meegan’s approach is to bring providers, public health officials, employers, insurers, and residents to the same table and focus on a few results:
- A clearer path to care. Help residents find an available primary care, dental, or mental health provider and understand coverage before they give up.
- Earlier help for mental health needs. Examine urgent community care and crisis response models so the emergency room is not the only door open.
- Prevention that earns its funding. Protect effective screenings and other services, then publish what they cost and whom they reach.
- Accountability for access and cost. Track appointment waits, unmet needs, avoidable emergency visits, and out-of-pocket barriers. Keep what works and change what does not.
Ottawa County families do not need another argument about whether healthcare is difficult. They already know it is. Joe Moss proposed reducing the county general-fund allocation for public health; the adopted budget differed from that proposal. Meegan Zickus wants to measure whether people can actually get care—and use the evidence to make it easier and more affordable.
Improving access also depends on provider capacity, staffing, insurance rules, and sustainable funding. Appointment availability and patient costs should be measured alongside public spending, rather than assuming either higher or lower spending guarantees better care.