Medicaid reform is the real issue

Lawmakers spend too much time on fraud.

A legislative committee was in Springfield on Wednesday looking for fraud in Medicaid.

Perhaps there is some to be found, but we suggest lawmakers are once again focusing on the wrong priorities when they talk about Medicaid. What they ought to be doing is figuring how they're going to remake the system. When the legislature slashed Medicaid two years ago to balance the state budget, they passed a bill that wipes out the current state system of state-funded indigent care by 2008. The plan, Gov. Matt Blunt and Republican legislators said, was to remake the system from scratch.

It stands to reason when the tenticles of government get intwined in areas which should be the private sector cost will definetly GO UP.

So what are they doing? They're still talking about fraud and abuse, which was their rallying cry when they made the cuts in the first place. In the meantime, real people are suffering. Children have lost their insurance. Disabled adults have quit their jobs to keep their Medicaid. We're about two years away from the system going away and we're nowhere closer to figuring out the plan to develop a sustainable Medicaid program.

If you look at the BUDGET for mediScare there wasn't a cut in cost or budget so how does the SNL proclaim there was one. Easy the electorate buys into it via the SOB stories we see on TV nightly.

The good news is that Blunt seems to understand the key issue. In an interview with the News-Leader editorial board recently, he decried the liberal myth that too many people in our system today don't have access to health care.

"Everybody has access," Blunt says. "It's the emergency room. We need to change that."

The irony, of course, is that was the Democratic criticism two years ago when he slashed the Medicaid rolls and forced too many folks to use the emergency room as their sole source of health care. That Blunt today understands that reality of our system speaks well for the potential reform of the Medicaid system, if only the governor and lawmakers can get past political hurdles and focus on the real issues.

Personally using the Emergency Room as my source of medical resourses isn't actually an intelligent idea. My pet ferret knows emergency room cost will skyrocket, so how come it is people with college degrees don't understand this?

Reforming Medicaid has little to do with fraud and abuse, and everything to do with determining sustainable levels of care that provide security for our state's residents who need it, but mostly as a transitional benefit, not a permanent state-provided health insurance system. The problem with the old system is that it grew out of control. Like other forms of welfare — from food stamps to public housing — it didn't provide the sort of flexibility that helps folks as they help themselves. Under the old way of thinking about welfare, services are provided until a certain income level is attained, and then they're cut off. That forces people who are still in poverty to choose between food and medicine, shelter or a better-paying job.

The new model of Medicaid, we believe, must include sliding scales of service that help those who need it most and charge co-pays — or slowly reduce services — for those who can afford it. The new model must reward those who improve their income by keeping services in place until folks have climbed out of poverty, rather than just cutting them off when an arbitrary new income level is reached. The new model must recognize the truth that Blunt realizes: sending folks to the emergency room is not a solution.

Remaking Medicaid should be about providing incentives for those who can help themselves and access to health care for those who can't.

It's time for state lawmakers to make real Medicaid reform a priority.