• More Medicaid

    If you are interested in The Great Medicaid Debates, the next thing to read is Harold Pollack’s latest piece. If you’re not interested in The Great Medicaid Debates (TGMD, shall we say?), you might want to ignore health policy for a while.

    About that, a question: what’s the next focus of the health policy debate, after the Medicaid issues fall away? One guess is that it’ll be a general re-litigation of health reform in the run-up to the 2012 election. Perhaps there are implementation milestones that will occur between now and then that will create focal points for debate. What do you think? What are the next issues and when will they come to the fore?

    Before answering, read Pollack.

    • I would expect the Medicaid debate to heighten. At the state level, with the ARRA money gone, Medicaid is one of their largest expenditures. As states look to cut their budgets, I would expect more Medicaid cutting.

      On the federal level, I expect nothing other than repeal efforts. Probably death by a thousand cuts. I agree with Ezra (I have been saying this for a long time) that the GOP just does not care that much about health care reform. It is never anywhere near the top of their concerns. They have never spent significant political capital on the effort. Medicare D to buy the votes of the elderly? Yes. Comprehensive reform? No. Even the parts that they claim to believe in, like malpractice reform or selling across state lines, have not been pushed for when they have had the opportunity. In the abstract they will say they would like to do something, in reality they are bonded to the status quo.

      BTW, Pollack’s piece was excellent. It reminds me of the GOP effort to support MA while talking about deficits. Roy and Goodman often make the case for free markets reducing spending while telling physicians that government is going to cut their income. The inconsistencies are galling.


    • Just curious… have business intellectuals ever hurt their heads on what would (or could) happen if Medicare Part D simply went away?

      Seems like Pharma still wants to sell their drugs in high volume. I assume that Part D was a rather generous handout to Pharma.

      What if the government simply said (in the name of serious debt reduction) this was one subsidy that they couldn’t afford anymore?

      Seems like this has to have been studied already (not by politicians – by businesspeople, who, I assume, do have a compassionate side too).

      Full disclosure: I didn’t even ask Mr Google the question – am hoping that the more intelligent community supporting this excellent blog will get me the answer more quickly!