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Labels: Health care, Medicaid
Health: Utah the Model for Medicaid Reform?
Since the former governor of Utah is now the cabinet official who oversees Medicaid, it may be worth looking at Utah's Medicaid system.
This New York Times article gives a brief overview:
Utah spreads out a lower, more basic level of care to more people, and reduces coverage for some traditional beneficiaries by imposing co-payments for services. And second, it relies on the generosity of doctors and hospitals to provide specialty services free of charge.
In the broad, Michael O. Leavitt, new HHS secretary, has it right:
"Wouldn't it be better to provide health insurance to more people, rather than comprehensive care to a smaller group Wouldn't it be better to give Chevies to everyone rather than Cadillacs to a few?"
A key part of any Medicaid reform is introducing people to the fact that health care is not free:
The plan is deliberately constructed with modest premiums and co-payment schedules, they say, to offer a lesson on how health insurance works to people who might never in their lives have carried a private policy.
But there is still a problem with the plan: it relies on generosity for catastrophic care. The ideal would be for people in the program to somehow obtain low-cost, high-deductible insurance policies (with accompanying health savings accounts) that would meet the gap. Together with the state's basic care package, people might actually have health insurance, rather than a package of prepaid health care services.
"Justice Louis D. Brandeis'?s metaphor of the states as "laboratories" for policy experiments ... had almost nothing to do with federalism and everything to do with his commitment to scientific socialism. .... To this day, it continues to inhibit a truly experimental, federalist politics." -- Michael S. Greve
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