Cut 10 Billion to Improve Medicaid?

Yesterday, a new Medicaid Commission was announced by Health and Human Services Secretary Mike Leavitt. This Commission, ostensibly "bipartisan", is given far-reaching orders. You can find the Medicaid Commission's Charter here.

Two diaries, one by nutmeg, the other by FleetAdmiralJ, have already focused on Sundquist, the former Tennessee Gov., Chair of this new committee, who was no friend of Medicaid. While they have covered his deficits very well, there is more to the story.

It should come as little surprise that the instructions to the committee are to recommend 10 Billion in cuts soon, and policy recommendations later. And with the time frame for cuts unbelievably short, it is inconceivable that the committee will have time for anything more than window dressing of Bush policies.

This announcement came to my attention through the fine work of FamiliesUSA - The Voice for HealthCare Consumers organization.

More below. .

The Medicaid commission will submit two reports to the Secretary of Health and Human Services. By Sept. 1, the commission is to recommend $10 billion in cuts for Medicaid over the next five years as well as long-term improvements to serve beneficiaries better. Also in this first report, the Committee is to consider potential performance goals for Medicaid as a basis of longer-term recommendations. The second report, due Dec. 31, 2006, will make recommendations to help sustain Medicaid over the long-term.

Eleven voting members and 15 non-voting members were named. As previously mentioned, former Tennessee Governor Don Sundquist (Rep.) will chair the commission, with former Maine Governor Angus King (Ind.) as Vice-Chair. Two voting seats are being held open until after September 1, 2005, when the "real" work of the Commission will begin, according the Secretary.

By my quick analysis, the voting members of the commission, excluding the Chair and Co-Chair, include 4 who are likely considered as liberals, and 7 who are conservatives, almost certainly Republicans.

The conservative (Republican) voting members of the Committee have in their histories these things, among others:  VP of the Family Research Council; Resident Scholar, American Enterprise Institute; Focus on the Family Board of Directors; former VP of the Heritage Foundation; advocate for health savings accounts; investment manager; although most are listed for their service in the current or former Bush administrations in HHS or other agencies.

The other voting members, likely Democrats, are a state health care administrator with rural focus, policy analyst for best practices to improve health care of the poor; director of policy center focusing on minority health issues; national advocate for persons with disabilities.
The nonvoting members span a range of health activities from the American Academy of Pediatrics to representatives of hospital associations, consumers, health corporations, local and state governmental units, drug store chains, and insurance groups. Conspicuous by their absence are any apparent representatives from the nation's outstanding Schools of Public Health and Public Policy.

As Ron Pollack, Executive Director of Families USA says:

The Commission's lack of credibility is underscored by its very first assignment. Less than eight weeks from its appointment today, even though no meetings have been conducted, the Commission is required to recommend how to slash $10 billion from the Medicaid budget.

This assignment flies in the face of common sense. Changes in Medicaid--the key health care safety net for 53 million children, seniors, people with disabilities, and others--should only occur after careful deliberation. Moreover, budget decisions should follow policy analysis, not vice versa, as the HHS Secretary has proposed.

There is no requirement--in the existing congressional budget resolution or otherwise--that $10 billion be cut from Medicaid. The resolution requires cuts of $10 billion from programs under the jurisdiction of the Senate Finance Committee, but it does not require $10 billion in Medicaid cuts.

•  Well, Medicaid is bloated

  And I think it is ridiculous to spend so much money on old people when young people don't have health care, don't have good public transit, have crumbling schools, and almost zero dollars are being put into renewable energy sources.

  Of course, I support Social Security and Medicaid/Medicare, but no one is gonna tell me that those programs don't have billions in waste and fraud and inefficiency. With Medicaid alone, I'm sure you could save ten billion by going after doctors who overcharge, charge for unnecessary procedures, or steal from the system in other ways.

  Spending on Medicaid is gonna skyrocket over the next few decades.  On behalf of young working folk, I think keeping the costs in check is a good thing. Which is part of why I strongly opposed the Medicare prescription drug plan. It's a nice idea, but 50 million people under 25 have zero health care. I think the latter is a bigger priority.

  by existenz on Sat Jul 09, 2005 at 10:05:11 PM PDT

  •  Medicaid covers many children

    In general, I agree that children get fewer federal dollars from almost any entitlement program that is available to both children and adults. My concern is not that Medicaid should be left untouched. My concern is that Medicaid cuts will be proposed very quickly, passed on voice votes, with little public discussion. Cuts will be fashioned to appeal to the voting constituencies of the Republic party, which does not include many poor families.

    The reality is that 1) children, compared to retired persons eligible for Medicare (and their adult children) do not vote. 2) Children's parents, by and large, do not vote in proportion to their numbers in the voting age population, and 3) They are much less important and easily written off by a lot of politicians.

    by Kidspeak on Sat Jul 09, 2005 at 10:39:09 PM PDT

  •  Goof, I ate my agreement with you!

    Sorry, I killed my first paragraph, which agreed with you almost entirely!

    You have an excellent point. Medicare is bloated, and the regulations work against sensible care policies for the elderly in many instances. However, I do not trust medical savings accounts to deal with long term care for the poor, especially, whether they are children or older adults.

    And the drug plans are straightforwardly hand-in-glove with Big Pharma, if they are turned over to Medicare.  

    by Kidspeak on Sat Jul 09, 2005 at 10:42:24 PM PDT

  •  You're only young a while, but ...

    you're old a long time. At least, if you're lucky enough to have health care. I hate to see generations pitted against each other. We must preserve the social contract between all Americans that ensures that those who can, help others while they can. We all need help sooner or later. Think what a rediretion of the Bush tax cuts and the funds for  War for Haliburton Indepence could do for health care. Not to mention the Big Pharma mess.
    They enemy is not the old or young, it is the greedy and selfish.

    by GKMscot on Sun Jul 10, 2005 at 03:56:58 AM PDT

•  More re: Medicaid cuts

  http://www.dailykos.com/story/2005/7/2/235041/8540

  details how Medicaid will no longer cover rx's, effective 1/06--rx's will be covered under the Medicare rx program.  

  one thing:  no one knows exactly how the program is going to work!!

  and

  http://www.dailykos.com/story/2005/7/3/14267/73048

  details my personal experience in having a prior-authorization for my rx's suddenly revoked!  (I am a traumatic brain injury survivor, and have been taking anti-convulsants for years to prevent seizures.)  And the lack of any assistance from my congresscritter!

  (Finally ended up getting the rx filled--the hoops that I had to jump thru were ridiculous, but now I have a pretty good idea of what the future holds!)

  by Street Kid on Sat Jul 09, 2005 at 10:11:05 PM PDT

  •  Correction re 2nd link:

    http://www.dailykos.com/story/2005/7/3/14267/73408

    by Street Kid on Sat Jul 09, 2005 at 10:15:10 PM PDT