Bacon's Rebellion

Democracy Thrives in Sunlight

Warner Goes National on Medicaid

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James A. Bacon
in

Gov. Mark Warner was interviewed this morning on NPR about Medicaid. As Chairman of the National Governors Association, he is the leading spokesperson for the states on this troubling issue.

Virginia has seen Medicaid spending go from $1 billion to $5 billion over the last 15 years. Warner identified three factors contributing to the rise: the Federal government push costs to the states, fewer employers offering insurance (in effect urging employees to go on Medicaid), and the “disinvestment” of senior citizen assets, making them eligible for Medicare funded long-term care because they are suddenly “poor.” As Medicaid spending surpasses education spending in states, Warner says a “grandma vs. grandkids” confrontation is being created.

The Governor sounded confident and in command of the issue. He deftly sidestepped a late question asking if the Medicare issue might make someone want to be president.

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  1. Jim Bacon Avatar
    Jim Bacon

    Medicaid is a tough policy nut to crack. There are no easy answers. Virginia already has one of the most restrictive Medicaid policies in the country, so there’s precious little room to cut back. Doctors and hospitals are getting way underpaid; many docs refuse to take Medicaid patients anymore.

    Gov. Warner identified one big problem–the scam in which old people transfer all their assets to their relatives then, declaring themselves penniless, go on Medicaid. He also identified the problem of small businesses not giving employees medical insurance benefits. Many of those employees end up as indigent patients — perhaps some of them wind up on Medicaid, but I don’t think many; if they’re employed, I believe, they have too much income to qualify — which puts additional strain on the health care system.

    A partial remedy is to focus on finding a way to provide affordable medical insurance for as many Virgnians as possible. That entails two broad strategies. First, as Tim Kaine has suggested, create a state-sponsored insurance pool that allows small businesses to share risk and access insurance on better terms. Second, as no candidate has yet advocated, eliminate the welter of mandated benefits that make it impossible for an insurance carrier to package a bare-bones but affordable insurance package. There should be alternatives between the mandated gold-plated policies and absolutely nothing at all. Instead of choosing between a the healthcare equivalent of BMW and a moped, Virginians should have the option of buying a healthcare Hyundai, Taurus or Explorer.

  2. Will Vehrs Avatar
    Will Vehrs

    The idea of setting up a pool has been around for some time. I don’t know what the hold up is … I guarantee there are plenty of state employees doing things much less important than signing up small businesses for an insurance pool.

  3. criticallythinking Avatar
    criticallythinking

    If there were savings in small companies banding together for health insurance, they would have already done it in the private sector, UNLESS there is a law preventing it.

    In which case the correct solution is to fix the law, not set up a new government program.

    And if there are a bunch of state employees running around with nothing better to do than administer private insurance programs, maybe we’ve found some more ways to save some of our hard-earned tax dollars.

    Of course, I’m not saying that there ARE such employees, I’m merely talking about what we should do with them if they do exist.

    And unfortunately, nobody can run on being able to identify Medicaid as a problem. It doesn’t take a genius or even a focus group to state the problem.

    Frankly, having a solution isn’t exactly the ticket to the presidency either — ANY president can steal a good idea. Policy wonks have good solutions.

    What is needed from a presidential candidate is the ability to “see into the future”, to see the problem, see who has a good solution, and sell it.

    Mark Warner is good at seeing problems (even where they DON’T exist), and he is great at selling people things whether they are good or not (for example, the 1.4 billion tax increase).

    Maybe Warner has what it takes to be President, but seeing that Seniors have figured out a way to get more money for themselves isn’t going to help him, especially if he thinks he can FIX it.

    Does anybody think a democrat can win the white house on a platform of depriving senior citizens of an ever-increasing share of the pie?

  4. Ray Hyde Avatar
    Ray Hyde

    Between Medicaid, collapsing retirement plans, the housing bubble, long term care, and a population that survives with increasingly expensive infirmities, my advice to anyone young enough to benefit is to invest in Aetna and Manor care, casket companies, funeral home chains, and the like.

    You might make enough money to pay your own health care costs.

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