Our Health Policy Matters

For over thirty years, states have tried and failed to contain Medicaid costs. And if they continue to do what they’ve always done, then “more flexibility” through block grants – code words for cutting people and benefits from the programs – isn’t going to help.   This is because the strategies they have used don’t work.   I wrote a few weeks ago about problems with some of the specifics of Florida’s Medicaid reform bill this year.   In this column, I want to add a more global perspective.   source: US DHHS, 2007 Between 1980 and 2004, total personal health care expenditures in the United States increased by 726%.   Total Medicaid expenditures increased by 1,028%.   That’s a pretty compelling opening argument against the four common “cost containment” strategies -- cutting provider rates; reducing the number of people eligible; eliminating chronic disease detection, prevention, and management services; and making recipients ...

For over thirty years, states have tried and failed to contain Medicaid costs. And if they continue to do what they’ve always done, then “more flexibility” through block grants – code words for cutting people and benefits from the programs – isn’t going to help.   This is because the strategies they have used don’t work.   I wrote a few weeks ago about problems with some of the specifics of Florida’s Medicaid reform bill this year.   In this column, I want to add a more global perspective.   source: US DHHS, 2007 Between 1980 and 2004, total personal health care expenditures in the United States increased by 726%.   Total Medicaid expenditures increased by 1,028%.   That’s a pretty compelling opening argument against the four common “cost containment” strategies -- cutting provider rates; reducing the number of people eligible; eliminating chronic disease detection, prevention, and management services; and making recipients ...

Legislators have created a Medicaid monster, which eats up 22% or more of their state budgets.   Now they want to slay it.   However, they’re not seeing the real monster clearly.   Cutting the legs out from under Medicaid recipients isn’t the same as cutting the monster down to size. A Florida bill illustrates how states are attacking the wrong things.   Under a Florida Medicaid reform proposal , Medicaid patients would be charged $100 for non-emergency visits to a hospital emergency room.   The purpose is to save money by discouraging unreasonable use of emergency rooms.   Nearly half of all visits to emergency rooms are for non-emergency reasons.   This is true of Medicaid patients, insured patients, and uninsured patients.   The main reason the percentage is so high isn’t that people choose to go to the emergency room for minor complaints.   Laypeople aren’t qualified to diagnose their own emergencies.   Health professionals tell...

Legislators have created a Medicaid monster, which eats up 22% or more of their state budgets.   Now they want to slay it.   However, they’re not seeing the real monster clearly.   Cutting the legs out from under Medicaid recipients isn’t the same as cutting the monster down to size. A Florida bill illustrates how states are attacking the wrong things.   Under a Florida Medicaid reform proposal , Medicaid patients would be charged $100 for non-emergency visits to a hospital emergency room.   The purpose is to save money by discouraging unreasonable use of emergency rooms.   Nearly half of all visits to emergency rooms are for non-emergency reasons.   This is true of Medicaid patients, insured patients, and uninsured patients.   The main reason the percentage is so high isn’t that people choose to go to the emergency room for minor complaints.   Laypeople aren’t qualified to diagnose their own emergencies.   Health professionals tell...