Thursday, November 17, 2005

Revisiting Medicaid

On Tuesday, State Assemblyman Dave Koon (D- Perinton, Penfield, Webster) was on the 1370 Connection on WXXI just taking calls concerning the election and general what-not. I built up a little nerve in the parking lot outside of Burlington Coat Factory in Henrietta and called in. I was the last caller taken.

I thanked the host, Bob Smith for taking my call and then directed my question to the Assemblyman. It was about Medicaid. My question was something like, "New York is number one with a bullet when it comes to state expenditures on Medicaid. We spend 33% more on the program than the next state, California, which has the 8th largest economy in the world. I'd like to know what the Assembly is doing, or what the Democrats are planning to do in order to rein these costs in?"

The Assemblyman didn't really evade the question or hemmed and hewed around it. He didn't really address it either. His answer concerned two things: the problem needs to be examined very closely, and they need to make changes without reducing the level of benefits. Host Bob Smith added to my question by addressing the potential that around 20% of state Medicaid expenditures are due to fraud. Again, the response was, it's something that needs to be looked at.

I'm not getting the impression that this is a real priority in Albany.

First, legislators need to start looking at the problem and finding ways to make sure that benefits are granted to those who need them. They shouldn't shy away from denying benefits to those who do not require assistance. By stating that we don't want to reduce benefits before even doing any serious accounting for where the cost centers are, is like tying our hands before we start bailing water out of our sinking boat. New York State is spends more than any other state. Why are we so out of alignment with states our size with similar demographics? This requires benchmarks. Ideally, we want to be right there in the middle of the pack.

Spending more than California should be a major wakeup call to everyone. Instead it's just not sinking in. The Rochester-based Rump Group has a great position paper concerning steps that can be taken to bring New York back in line with where it should be. The Democrat and Chronicle also runs special reports concerning Medicaid which they archive in one place. I highly encourage both social progressions and fiscal conservatives to examine these resources. This is a case where New York State can be doing more with less.

Furthermore, the allegations of fraud in the Medicaid system falls squarely to the State Attorney General to investigate and take action upon. Let it never be said I go easy on Democrats. Elliot Spitzer needs to tackle Medicaid fraud squarely in the next year or I will find it very hard to take him as a genuine advocate for the people of New York. I will not diminish the things he did on Wall Street, but if he isn't addressing the potential of fraud costing the tax payers of this state in the ballpark of $8 billion, I'm not sure what his motivations for seeking the Governorship are. I will tell you this, Golisano will be addressing Medicaid (he is a member of the previously mentioned Rump Group), Bill Weld will be addressing Medicaid (Massachusetts had sky-rocketing Medicaid costs before Weld reined them in. Now Massachusetts is considered one of the states New York should benchmark itself against.), and they will both look to Spitzer and ask why he hasn't done more to address the fraud in the system. It infuriates me to see Spitzer allowing such a huge opening for which his two major opponents will be able to directly flank him and hit him on a major issue.

What's more important though, is that the problem gets fixed. If Spitzer isn't willing to do it, he should sit down and get out of the way of people that are willing to. If that means I vote for someone else for Governor next year, than I'll do so happily.