Tom Campbell host of NC SPIN writes about the complications of Medicaid in North Carolina, published on the June 23, 2012 Wilmington StarNews OPINION page (not available online). Mr. Campbell discusses the complexity of this massive, costly federal program (self?) imposed on the states to administer. Campbell lists three “variables”: eligibility, services and payments to providers that “affect the size, scope and cost of this behemoth program.”
Medicaid gobbles up an inordinate amount of state spending—and it increases rapidly. Spending from North Carolina’s General Fund has tripled to more than 15 percent in the past ten years. Obamacare will add 600,000 beneficiaries to the 1.6 million now on the Medicaid dole in North Carolina. Taxpayers here contribute $3 billion to the current $12 billion annual cost.
Medicaid costs state taxpayers more than $8,000 per enrollee. Our neighbors in South Carolina paid about $6,900 per person and Georgia taxpayers paid nearly $5,500 in 2010, according to data from Joseph Coletti of the John Locke Foundation. (link)
Campbell suggests three “actions our leaders should take right now to set this program on a better course.” Legislators should “immerse themselves” in studying the program; they “must reach consensus” about the basic goal; and they must “design a comprehensive plan” to achieve the goal. But this vague and bureaucratic language doesn’t get to the heart of the problem.
Mr. Coletti recommends some concrete solutions. He suggests that the feds should give block grants to states that would give them “freedom to reform Medicaid.” Central bureaucratic control now prevents innovation that only states can provide. Coletti also recommends that states provide “risk-rated subsidies” to Medicaid recipients so they can purchase private insurance. Finally, Coletti thinks that private sector health savings accounts will help prevent fraud and abuse—major Medicaid problems—and reduce costs. Others have also described needed reforms.
About a year ago the JLF published a policy report by Brian Blasé and C. L. Gray that details the problems with Medicaid and how to reform this fiscally irresponsible program. (link)
Medicaid along with huge liabilities for other healthcare and pension entitlements at every level of government must be controlled or future generations will find they are financially crippled with unsustainable debt and taxes—nothing complicated about that reality.
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