Medicaid Reform

Dear Friends and Colleagues:
Attached two letters to the editor published in the Miami Herald. The first by our very own Dr. Arthur Palamara cautions against the expansion of the Medicaid reform program into Miami-Dade County.His letter from April 22nd is a response to the letter from Representative Galvano published on April 19th.
I congratulate Dr. Palamara to his pointed response. We have to be careful to let ideology trump reason. Based on the best evidence the current Medicaid pilot program in Broward county has not met the expectations, or (less euphemistically) has failed.
We should not jump on the Medicaid reform bandwagon but review the results of the current pilot.
Further reform implementation should be based on facts and not wishful thinking. We need to solve the problem of Medicaid financing and protect healthcare for those in need.Our voices need to be heard and I encourage you to particiapte in the political debate.
Yours
Bernd

Posted on Tue, Apr. 22, 2008
Flaws in Medicaid
Re state Rep. Bill Galvano's April 19 letter, Expand Medicaid reforms: His assumptions of improved care for Medicaid patients are unsubstantiated. If anything, the contrary is true. Medicaid has regressed from a coordinated system of services to one that is highly fragmented, erecting innumerable obstacles for patients and providers.

Transfering healthier patients into for-profit HMOs leaves sicker and more-debilitated patients in the public-supported Provider Service Networks (PSNs).

Escalating costs suggest that neither of the two Broward Hospital District's PSNs will participate within a year.

While Medicaid reform may look good on paper, Broward's experience suggests that it does not function as designed. The Florida inspector general and the regulatory Agency for Health Care Administration recommend that the program not be expanded until additional data are accrued.

While the Legislature's desire to curb expense is appropriate, its parsimony should not be borne on the backs of Florida's most vulnerable patients.

ARTHUR E. PALAMARA, M.D., Hollywood
Posted on Sat, Apr. 19, 2008
Expand Medicaid reforms
More than 400,000 residents of Miami-Dade County depend on Medicaid. They have limited resources; many of them have serious, chronic disease or disabilities. They have no other source of healthcare coverage. They need and deserve our help -- not just more money, but better care and better results.

It is time to expand Medicaid reform to Miami-Dade because reform offers a better way. The current Medicaid system is flawed. Although Medicaid seems to offer an extensive menu of services, access is uncertain, coordination is random and outcomes are unknown.

Medicaid reform puts patients first. In current reform areas, participants have more plan choices. When they select a plan, they are choosing a unique set of benefits. Reform plans are offering new services -- the first time Medicaid ever expanded services without additional funding. Preventive dental care for adults and over-the-counter drugs are two of the most popular add-ons.

In the second year of reform, four plans expanded the extras and four more added benefits. Reform plans also reduced patient cost-sharing. Reform offers incentives for healthy behaviors. The key to making Medicaid serve patients better is to make the patients themselves the bellwether of success.

To bring state spending back within bounds, Medicaid funding -- now 27 percent of Florida's budget -- must be reduced. We can cut eligibility, eliminate services or reduce prices. Medicaid reform offers a better way by providing incentives for innovations that deliver services more efficiently and effectively and the tools to manage Medicaid in a way that best serves both patients and taxpayers.

REP. BILL GALVANO, chair, state House Committee on Healthy Families, Bradenton