Monday, March 14, 2005

Medicaid

Rich Miller reports, Illinois [is] one of only two states, along with Maine, that is still actively expanding its Medicaid rolls. [...]

My analysis is that health care costs are choking state and local government. Expanding the state's obligation seems particularly short-sighted.

14 Comments:

Anonymous Anonymous said...

You make a fair point, but I offer two additional perspectives:

1) If you care about the basic needs of low-income families, Medicaid expansion is a good thing. Recent expansions have extended coverage to low-income children and their parents, thereby improving access to primary and preventive care and, presumably, diminishing the need for more expensive interventions(which is good, given the inconsistency, and inconsistent application of, Illinois hospitals' charity care policies). Also, these new enrollees do not tax the system nearly so much as long-term care for low-income seniors and coverage for people with disabilities.

Also, the policy of expanding Medicaid in Illinois may be part of an effort to bring money in -- the federal government matches Illinois' Medicaid spending dollar for dollars.

3:03 PM  
Blogger Carl Nyberg said...

Thanks for the education on leveraging state spending for federal dollars.

The economics of health care needs to be fixed. The market isn't delivering what the customers need.

5:21 PM  
Blogger Dan Johnson-Weinberger said...

I think this is the opposite of a Blago blunder. Investing in health care is great, and we should applaud Blagojevich and the General Assembly for doing so.

6:29 PM  
Blogger Carl Nyberg said...

If Blago is going to expand health care entitlements, shouldn't he wait until he's got the budget balanced?

The health care system is a mess. Expanding Medicaid doesn't fix this.

7:17 PM  
Anonymous Anonymous said...

It's hard to be opposed to health care for low income families and kids.

I have not seen any numbers, however, on what percentage of Medicaid dollars are spent on these low-income families and kids vs. nursing home care not only
for low-income seniors but also for
middle class seniors who divest themselves of their assets so as to be eligible for nursing home care. Also, to what extent is the state supporting in-home care and hospice care with one's family vs. expensive institutional care, both for the elderly and disabled, as well as mental health and child welfare populations. In-home care is less expensive but, more importantly, it is far more humane.
How many of us happily envision dying in a nursing home or hear stories of children growing up in foster care without flinching.

The governor deserves huge credit for holding the line on income tax increases. But the next step is to
find creative, less costly solutions to problems such as Medicaid funding and pension reform. That's where he seems to be stuck.

11:40 AM  
Blogger Carl Nyberg said...

I favor universal health care with effective cost controls.

Blagojevich's proposal accomplishes neither of these goals.

What's with people who claim to be part of the party of FDR/LBJ fighting for health care for the lowest 15% while a large number of working people in the 40th percentile are without health care themselves?

Doesn't this make the Dems look like the party of poor Blacks? Dems love to kvetch about losing lower-middle class "Whites". Dems claim these lower-middle class "Whites" are racist. But the Dems don't do much for these people.

But I digress...

8:09 AM  
Blogger Carl Nyberg said...

BTW, NPR's All Things Considered did a segment on Maine's Medicaid expansion. It does contain significant cost containment features.

8:13 AM  
Anonymous Anonymous said...

Carl,

Do you favor public subsidies of private health-care providers?

12:12 PM  
Blogger Carl Nyberg said...

I favor universal health care and controlling costs.

12:53 PM  
Anonymous Anonymous said...

Okay, universal - everyone has access and it is publicly financed. However, who provides this "universal" care? The public or the private sector? Will there still be private practice physicians?

2:28 PM  
Blogger Carl Nyberg said...

Can the United States provide universal health care? Yes.

Can costs be contained or reduced? Yes.

Does it matter if the system is "public", "private sector", hybrid or other? This is much less important to me that the other two issues.

What's the point you want to address about public vs. private, anon?

3:34 PM  
Blogger Carl Nyberg said...

What makes a physician public or private?

8:13 PM  
Anonymous Anonymous said...

How would you "control" costs? That should get you thinking about the public - private difference.

If not, I will explain further.

11:52 AM  
Anonymous Anonymous said...

CN commented that "the economics of health care need to be fixed." If you haven't already seen it, I suggest checking out the March 7th issue of the New Republic, which featured an article by Arnold Relman entitled "The Health of Nations." It's available online, though it may require a subscription.

12:49 PM  

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