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12/21/2010
On Medicaid - support your courageous state legislators

Several folks yesterday asked if I’d seen Sunday’s 60 Minutes. Well, no, I didn’t. But the frequent mentions of the “Day of Reckoning” segment with Governor Chris Christie tell me voters – and more importantly taxpayers – are finally getting it. Public sector pension promises are a problem. A huge problem.

FoxPolitics News readers are no strangers to word of state and municipal budget challenges and the part pensions and health benefits play in many states' looming deficits.

The Heritage Foundation used Sunday’s 60 Minutes show to emphasize yes, the public pension situation, but also the really big elephant in the state and local budget room – Medicaid.

But as bad as government union contracts and pensions are, they are not the real driver of state insolvency. Medicaid is. Already, Medicaid is the second largest item on the average state budget at 21% (education is first at 22%). But according to the Centers for Medicare and Medicaid Services (CMS) that is all about to change very soon thanks to Obamacare. Remember, more than half of the health care coverage expansion under Obamacare is attained by placing Americans on Medicaid. CMS projects that state and local spending on Medicaid will increase 41.4% between 2010 and 2011. 41%!!!

Heritage has written volumes on the Medicaid problem – most recently, yesterday afternoon.

Unfortunately… the [deficit] commission’s final report “took a pass on offering any concrete, long-term recommendations” for Medicaid reform. [Paul Ryan kept the health care omission front and center in his comments and explanation of his “No” vote.]

…. Obamacare did little to solve the issues afflicting current Medicaid beneficiaries or put the program on a fiscally sustainable path. It will actually put Medicaid in worse shape by adding nearly 18 million Americans to this poorly performing program.

And, The Heritage provides solutions!

If Washington won’t take the lead in Medicaid reform, states should. In a recent paper, Owcharenko outlines the way forward after Obamacare, writing that states should begin by assessing the specific needs for change within their own Medicaid programs. They should then challenge the one-size-fits-all approach of Obamacare and demand more flexibility to implement reform, moving toward a system that is both sustainable and provides low-income Americans with the same quality of care available to the privately insured.

By taking a bottom-up approach to reform, states can lead the way to transforming Medicaid into a sustainable program that better serves its beneficiaries.

Our state lawmakers will need our support in reining in spending. Medicaid is no exception.

Jo Egelhoff, FoxPolitics.net

COMMENTS

Why is "reining in spending" your priority? Seem to me that Medicaid serves a useful purpose in providing care and reducing health care costs overall. How is it funded and should that be changed? Could it's administration be improved?

From what I have found in regard to Medicaid it appears that it is a small step toward single-payer for all, something we should all be striving for.

Dean Weichmann (Tue Dec 21 10:39:31 2010)

Cutting spending is imperative is this country is going to remain in any kind of fiscal shape. You do this by some of what you suggest which is is it administered properly? (Practically nothing in the government is.)

Is it funded properly? ROTFLMAO Do you suggest taking the money out of the front taxpayer pocket and put it in the back pocket? All the money government has it takes from taxpayers? No matter how it's funded it still boils down to that.

Government doesn't make money except by taking it away from its citizens. I read an essay once in which the writer claimed the U.S. government "extorts" money from its citizens because when it wants your money it says, i.e. "give me this certain amount of money or suffer the penalty."

Dean, government is the only answer you ever come up with. You give me one situation that government actually improves and I can give you a hundred where it worsens it and healthcare happens to be one of the worst although banking runs it a close second.

Government has been meddling in medicine ever since I can remember. Congress and the president pass mandates for doctors, hospitals, insurance companies and any other related medical businesses (yes, businesses)and then they're on their own except for an occasional inspection and or directive..... you must buy a whatsis for your thingamabob or people will die ..... then they leave and the business is left to figure out how to best accomplish this. Oh wait, I know how. I'll raise my prices.

The customer (that's you and all the other Joe & Jane Taxpayers) is the one who always pays.

I wish you a very Merry and Blessed Christmas and a properous New Year to follow.

C. R. Stevenson (Tue Dec 21 16:42:52 2010)

>>>Dean, government is the only answer you ever come up with.<<< Don't get me wrong CR, I would not want everthing run by government either but I am not blinded by your faith that business is always better than government. A large corporation has bureaucracy just like government but is driven primarily by profit, not the common good. >>>You give me one situation that government actually improves and I can give you a hundred where it worsens it and healthcare happens to be one of the worst although banking runs it a close second.<<<

How about a comparison of health care costs among devoloped countries? Almost all other devoloped countries have some form of single-payer health care (government run) and have similar health statistics.
UK, (socialised medicine),$2,560
Denmark,$2,780
Canada,$3,173
France, $3,040
US, $6,096

(Tue Dec 21 21:09:37 2010)

>>>Dean, government is the only answer you ever come up with.<<<
I would prefer small business over government or big business. I do not have the faith that you have that big business has interest in the common good.
>>>You give me one situation that government actually improves and I can give you a hundred where it worsens it and healthcare happens to be one of the worst although banking runs it a close second.<<<

How about this; the cost of health care in other countries, almost all are government run.

Canada 3,173
Sweden 2,828
Japan 2,293
France 3,040
United States 6,096
Denmark 2,780
UK 2,560

Dean Weichmann (Tue Dec 21 21:18:54 2010)

I forgot to post the link for the information above. l

Dean Weichmann (Tue Dec 21 21:23:47 2010)

Dean, you just do not know what you're talking about. In order to get ANY kind of decent care at all in the UK, people buy PRIVATE HEALTH INSURANCE. So right away, all those people are not counted in the "cost".

Anybody who is retired is at the very bottom of the list. My mom-in-law had terminal cancer, and was so weak she kept falling. My inlaws took her to drs numerous times, and were told "she's just getting old". The dr didn't even do a urinalysis, a cheap in-office test! (UTIs are often a cause of weakness in elderly.) Only when my bro-in-law got her in to see a private dr, did they get a diagnosis. She was dead 4 months later.

Even younger people have problems; they may wait up to a year to even SEE an oncologist, then up to THREE YEARS to get treatment. This is what you get with single-payer. To many Brits, this actually is acceptable, and what they expect. Get ready to expect it here!

The reason for all the money wasted in the US, is GOVT INTERFERENCE. Back in the 40's Congress froze wages. Companies were desperate for workers, so they started offering major medical as a way to entice people to their workplace (govt forbade them offering more money). That morphed into "health insurance", which is a major middleman between the dr. and patient.

Prior to Congress' meddling, people paid their drs the way they paid everyone else: DIRECTLY, and costs were low. How cheap do you think a plumber or electrician would be, if they had to employ special office personnel to code and submit their bills to a giant company, with numerous employees, which them would pay them about 55% of what they asked!?

My mother can remember a time when the local GP was able to repair a torn jugular (yes this really happened.) A man somehow shot a hole into his jugular with a BB gun. His friend put his hand over the hole, and walked him to the GP's office, where the dr repaired it right then and there, and they paid the dr directly. Today, this would be a major emergency, involving ambulance, helicopter, vascular surgery, etc. That is, if the friend had the presence of mind to cover the hole in the first place.

What we need is MAJOR MEDICAL only, and pay the rest out of pocket; watch costs plummet if that were done!

emily matthews (Wed Dec 22 07:51:39 2010)

>>>Dean, you just do not know what you're talking about. In order to get ANY kind of decent care at all in the UK, people buy PRIVATE HEALTH INSURANCE. So right away, all those people are not counted in the "cost".<<<

Emily I think that is you who has no clue... How about you prove your point? Do you have some evidence beyond anecdotal?
I did a little more research on UK health.

>>>Although the NHS has a high level of popular public support within the country, the national press is often highly critical of it and this may have affected perceptions of the service within the country as a whole and outside. An independent survey conducted in 2004 found that users of the NHS often expressed very high levels satisfaction about their personal experience of the medical services they received. Of hospital inpatients, 92% said they were satisfied with their treatment; 87% of GP users were satisfied with their GP; 87% of hospital outpatients were satisfied with the service they received; and 70% of Accident and Emergency department users reported being satisfied<<<
http://en.wikipedia.org/wiki/Healthcare_in_England

Dean Weichmann (Wed Dec 22 08:58:50 2010)

How about wait times?
http://notmymothersblog.com/2009/04/24/the-myth-of-canadian-health-care-wait-times/
>>>I don’t think my parents are the exception to the rule, either. I suspect that if we looked at things more closely, we’d find out that in fact, we ALREADY wait at least as long if not longer for most typical health care services as do those people covered by universal nationalized health care in other countries. In addition, nearly every report that I’ve seen points out that our health care, overall, is lower quality than the overall standard of health care in those other countries. And – we pay more. We pay for it out of pocket. We pay for it in health insurance premiums – and then we pay even more out of pocket in co-pays, exclusions and spend-downs.<<<

So I guess the question is – why are we so invested in maintaining the fiction that health care reform results in substandard care and longer wait times, when all the evidence points to the exact opposite conclusion?

Dean Weichmann (Wed Dec 22 09:42:35 2010)

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