Thursday, October 27, 2005


Clear-Cutting Medicaid

Instead of running things through Congress, the Administration is simply cutting programs by sliding around the issues. The new Medicaid program for Florida is a test-run for a new and meaner approach. This approach will put spending caps on each Medicaid patient’s care.

Each Medicaid recipient must join an HMO. The government will then send the HMO a check corresponding to what the recipient’s recent medical history has been. Should that patient in the past needed $500 worth of care, then the check will be appropriate to that amount. Should some major emergency—a transplant, say— come up that will cost, maybe $200,000, more money from Medicaid. The patient will have to argue with the HMO. A cap is put on how much medical care is available for each person. Need radiation? Sorry, there’s no money. You have major broken bones that need fixing? Sorry, you’ve already reached your spending limit.
There’s no money, pleads the federal (and state) governments. Well, there isn’t any money because taxes have been clear-cut. There’s still money to fight a dishonest dirty war—or to build bridges to nowhere special, but none, they say, for health care.

This is obscene.

Thursday, October 27, 2005 - 12:00 AM

Washing their hands of the sick and poor.

Let's get something straight right now. Few government programs are "unsustainable." A program is sustainable if government chooses to sustain it. Governments keep programs afloat by giving them money.


True, public resources are finite, and there are things to spend money on other than health care. Education, for example. But then you have leaders like*** George Bush on the federal [level] who refuse to collect enough tax revenues for these programs. They then declare the cupboard bare and pretend there's no choice but to tighten the screws on poor people.

So what happens when unemployment rises or a dozen big employers decide to stop providing health benefits? Government could simply plead poverty, squeeze the per-person limit for coverage and let the insurers deliver the bad news to patients. ...[this] in effect, helps government wash its hands of the very sickest Medicaid patients.


A moral society ensures that basic human needs are met, and health care should be one of them. We all know that the demand for medical services is a bottomless pit, and taxpayers can't fund every expensive treatment someone might want. But a rich society that does not guarantee its citizens a reasonable level of health coverage is not to be admired.

If, rather than tax themselves, Americans let poor and working-class neighbors suffer and die for lack of adequate health coverage, they should at least be honest about it.

Providence Journal columnist Froma Harrop's column appears regularly on editorial pages of The Times. Her e-mail address is

Copyright © 2005 The Seattle Times Company

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