The danger of misreading a report

The danger of misreading a report

- in Fitzsimon File

The recent report about the rising cost of Medicaid from the N.C. Center for Public Policy Research has some sobering news for policymakers, most notably that the rapid growth of the state's aging population will spur even more increases in Medicaid spending and significantly increase the percentage of the state budget that will pay for the program.

That's important information for state budget writers to digest, but let's hope lawmakers consider the numbers in context and resist the knee-jerk Medicaid-bashing by the anti-government groups and right-wing legislators whose objections to the program are more driven by ideology than fiscal concerns.

Another report that concluded that health care costs are a dramatically increasing percentage of the state budget might lead thoughtful policymakers to decide that we need comprehensive health care reform that includes cost control measures.

But that might interfere with the holy free market and more importantly might affect the billions in profits of insurance companies and the pharmaceutical industry. And goodness knows we can't have that.

But when it's Medicaid, a successful public health care program that's under consideration, it's time to cut back, reel in government spending and reduce service for peoples who the folks on the Right think ought to take greater responsibility for their own care.

Medicaid costs are the fastest growing in the state budget because health care costs are the fastest growing in every budget. But considered in the context of overall health care, Medicaid is working. In 2007, it covered 1.7 million children, seniors, the blind and people with a disability without much of the administrative overhead in the private health care industry.

And it is not a government program for everyone who is uninsured. Most uninsured adults do not qualify for Medicaid regardless of their income levels. It is a program targeted at specific groups of the state's most vulnerable people.

The attacks on Medicaid are not new and just a result of the current economic crisis. The Locke Foundation has long called for cutting back Medicaid benefits and just providing ones mandated by the federal government. Those optional benefits include luxuries like medicine, ambulance care, physical therapy, and artificial limbs for people who lose an arm or leg.

State Health and Human Services Secretary Lanier Cansler told lawmakers recently that the state may have to stop covering some services to reduce costs. He mentioned services like hospice care, transplants, and respiratory care for children. Those don't sound too optional either.

The Lockers point to other states with lower Medicaid costs to support their claims that North Carolina's benefits are too generous but the N.C. Center's report says the state ranks 9th in Medicaid spending, hardly unexpected in the 10th largest state.

Medicaid may wind up $250 million over budget this year because enrollment increases are greater than projected given the slow economic recovery and the federal government has taken longer than expected to approve some cost-saving measures proposed by DHHS.

The Center's report includes some important recommendations, like expanding the state's Community Care Program that provides patients a medical home for their care and treating more elderly patients in their homes instead of more expensive institutions.

Those make sense and so do proposals like preferred drug lists to hold down pharmaceutical costs, which the drug companies oppose for obvious reasons.

But there is only so much the state can do to control Medicaid spending without hurting the people the program is now serving.

Significantly reducing its costs means tackling rising overall health care costs and the industries that currently profit from them. Until then, enough with the Medicaid bashing. It is actually a success story, an effective public health care program that serves millions of people who need help.

About the author

Chris Fitzsimon, Founder and Executive Director of N.C. Policy Watch, writes the Fitzsimon File, delivers a radio commentary broadcast on WRAL-FM and hosts “News and Views,” a weekly radio news magazine that airs on multiple stations across North Carolina.

chris@ncpolicywatch.com

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