Medicaid Reform: Different approaches but one correct answer

In the current edition of the South Florida Business Journal (October 22-28th,2010) the two gubernatorial candidates, Alex Sink (D) and Rick Scott(R)), answered questions related to the business climate in Florida.

One of them pertained to the future of Medicaid:

SFBJ: Would you make any changes to Florida’s Medicaid system, in areas such as provider funding, eligibility or the continuation of the Medicaid reform pilot program?

Sink: I will form a task force of all Medicaid system stakeholders to develop solutions for reducing this program’s burden on the state budget, and explore ways to address rising costs without jeopardizing the quality of care. Medicaid reforms are needed, as the program consumes about a fourth of the state’s budget; however, policymakers should ensure that changes actually work before imposing them upon the entire state.


SFBJ: Would you make any changes to Florida’s Medicaid system, in areas such as provider funding, eligibility or the continuation of the Medicaid reform pilot program?

Scott: I will seek a Medicaid waiver in order to allow Florida to create a voucher program in which Medicaid recipients would be able to shop for insurance on the private market. If we were not able get that waiver, I would seek to expand the Medicaid reform pilot program.



Comment: Medicaid reform pilot programs are solely intended to reduce the rapidly increasing Medicaid cost in Florida ($17.9 billion for the 2.6 million recipients - one out of every seven residents - and an 11 percent rise from the previous year) . But whats the reality? Doctors are complaining and refuse to participate because of low payments. Patients complain about delayed and limited services. Who does not complain? HMO's because they get the state contracts to care for Medicaid patients.

Vouchers: The argument sounds compelling. You provide Medicaid patients with a voucher and they can choose their own insurance and providers. The only problem: there are hardly any choices! Doctors drop out of Medicaid due to low payments and the insurance policy options are limited and contracts littered with exclusion criteria and limitations.


So if doctors are wary about Medicaid reform pilot programs why does organized medicine ENDORSES Rick Scott? Shouldn't we endorse the candidate who wants to ensure that changes actually work BEFORE imposing them upon the entire state? Please explain.


Bernd