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9/12/2009
Rep. Montgomery: Reining in the cost of health care – the Wisconsin experience
On Wednesday evening, President Obama spoke before a Joint Session of Congress to announce his plan for health care reform. Among the stated goals of his plan – rein in the cost of health care for families, business, and government. Making health care more affordable is a laudable goal as the rising cost of health care is among our nation’s most pressing problems.
Controlling health care costs, however, is much easier said than done. The solution is as complex as the problem and I am skeptical about expanding the role of the federal government to accomplish this goal. The reasons behind this skepticism stems from the recent history of the Medicaid program in the State of Wisconsin. Please allow me to elaborate.
By way of background, Medicaid was created in 1965 through Title X1X of the federal Social Security Act to provide low-income families, the elderly and disabled individuals with access to quality health care. Medicaid (MA) is a joint federal-state program with the federal government responsible for setting standards for health care delivery, eligibility and quality and state governments responsible for program administration. MA is funded through a combination of federal and state dollars most of which is generated through taxes. From its humble beginnings in 1965 as a health care “safety net” program to the present day, MA has evolved into one of the largest government programs at both the federal and state level.
When Governor Doyle took office six years ago, approximately 688,000 adults and children were enrolled in Wisconsin’s MA program. Two years from now, state MA enrollment is projected to approach 1 million. With the blessing of the federal government, Governor Doyle has proudly overseen the expansion of the state’s MA program, the latest of which extends health care coverage to childless adults. Over this same time period, the annual cost of MA and MA-related programs has increased from $4.3 billion to an estimated $6.3 billion by mid-2011.
In the best of economic times, these cost increases put a tremendous strain on the state’s finances. Wisconsin’s recent budget deficits and the current economic recession have only served to make matters worse. Efforts to rein in the costs of the state’s MA program have proven to be equally difficult.
From the day he took office, Governor Doyle has said that any reductions in either Medicaid participation or benefits are “off-limits.” As a result, MA funding increases have been supported through higher state taxes on individuals and businesses, nursing home beds, hospitals and cigarettes. Trust accounts, such as the Injured Patients and Families Compensation Fund, have also been raided. Even with all these new revenue sources, MA costs are outpacing revenue growth.
To close the gap, the state’s new two-year budget directs the Wisconsin Department of Health Services (DHS) to reduce Medicaid expenditures by $625 million. This week, the Wisconsin State Journal reported that DHS was going to delay $133.5 million worth of payments to Medicaid providers to meet this cost containment target as well as begin to reduce payments to the health care professionals and health care facilities for the care they provide to MA patients.
Accounting gimmicks that push off the problem into the future hardly represents a good faith effort to rein in costs. That being said, the reduction in payments to MA health care providers has far-reaching implications for those Wisconsin individuals and families who receive health care coverage through their employer or purchase health insurance on the open market. The consequence of this action is a “hidden tax” that health care providers shift on to cover their losses in caring for MA patients.
To bring closure to this brief bit of history, I call to your attention the following statement from a newspaper article in yesterday’s Business Journal of Milwaukee: “Wisconsin Governor Jim Doyle said Thursday that much of what President Barack Obama outlined in his speech to Congress Wednesday night on health care reform is already being done in Wisconsin with the state’s BadgerCare (MA) program.”
Clearly, Wisconsin is among the nation’s leaders in providing its citizens with access to high quality health care. We need to make sure that this type of care remains accessible and becomes more affordable. This will require a collaborative effort involving more than just the federal and state government. We should look to emulate and\or consider some of the successes in achieving these goals that are happening right here in Northeast Wisconsin and let’s take the time necessary to fully inform the public and get it right.
Phil Montgomery is a Republican and represents the residents of the 4th Assembly District.
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• Does most of the public fall for this stuff?
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• Blame it on the outmoded computers
• Scott Brown victory does not scuttle health bill
• 8th Congressional Candidate Forum, Jan. 25
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• MORE taxes on investment income - dreadful and wrong
• Join the blaze orange army and say ‘Enough is Enough’
• The future of government-run health care
• Tax on banks is a really bad idea
• Roth, Savard on the stump, grassroots style
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• Rahmlow: Savard, Bies frontrunners for State Senate
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• Why am I not surprised?
• Talk health reform with Feingold (Th), Petri (today)
• Give the Mayor power over MPS - if he can break contracts
• Burri: Yup, Dems really are going to bypass a conference
• The $2.7 billion Wisconsin deficit no one told you about
• Walker launches county accountability website
• Rahmlow: Why is Van Hollen dodging the Nebraska deal?
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| 2009 |
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• The Lawton-Bader files
• Yup, it’s the TAX LEVY, not the tax RATE
• Ellis: costly automobile insurance laws must be rolled back
• If not Barrett, who?
• The subsidy game
• Burri: Bailouts, Banks, Health Care, and the Mob
• Attend Appleton Schools budget meeting tonight
• A public option WON’T increase costs? That’s delusional!
• Appleton Schools budget meeting Monday
• Wisconsin should be screaming for accountability
• Burri: If anything, we need more obstructionism around here
• WI on the leading edge - in the wrong direction
• Rep. Montgomery: Utility Customers Join State’s Crime-Fighting Efforts
• Public Conservation and Recreation Lands Total 16.5% of State
• In the crow's nest of the Titanic, shouting 'Iceberg!'
• Is Rep. Nelson a political hack?
• Health care: The road ahead will be brutal
• Kagen's pandering again
• Birthers - good stuff for you
• How much do we bend over backward for seniors?
• The trouble with health care is paying for it
• Two-parent families: The Gold Standard
• Burri: Kids... the joys and blessings
• Very, very worried about health care
• Rep. Huebsch: Wisconsin is proof government health care isn’t the answer
• School district contracts push up tax levy
• What? Obama, the Peace Prize?
• TODAY - hearing on Campaign Finance Reform
• Appleton School District tax levy up way too much
• CBO report is out - and the bill isn't even written yet?
• So, how much do YOU budget for health care?
• Burri: Copenhagen trip was amateurish
• “Sotomayor, you have blood on your hands...”
• Cap and Trade. Always follow the money
• Rep. Kagen gets (almost) free health services
• I actually agree with Rep. Kagen
• Future Wisconsin Conference for Conservatives, October 10, Wauwatosa
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• Important votes Tuesday, including Appleton Common Council
• Democrats are becoming supply siders??
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• From Mark Gundrum: One of the greatest honors an American can experience
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• Joe Martin the best candidate in Appleton's 8th
• State programs to cut? - Volume II
• Oh the naivete of youth
• Not just disingenuous - flat wrong
• Steve - you will be missed
• Make cuts only AFTER you're elected....
• Getting serious: What programs can we cut?
• Rep. Steve Kagen joining me on Jerry Bader Show today
• Rep. Van Roy: Dental Care Pilot Program
• Has Dave Obey turned the corner on earmarks?
• Speaker Huebsch: Governor turns down Federal Aid?
• Mark Rahmlow: "We're Broke."
• As taxpayers, how do we know if it's a Chevy or a Lexus?
• This is trash talk - about a veteran
• Frank Lasee: Take time to get the Compact right
• 'The Gableman Ad' - is it racist?
• Roth thankful, Kagen shaking money tree
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• Losing the Hastert seat is NOT a trend and NOT curtians for the GOP
• First suggestion for 'slashing' programs
• Big money-saver for municipalities
• More one time fixes. Nuts.
• Any chances???
• I'm doing the Jerry Bader Show, today, the 11th
• Representative Frank Lasee: Final Waltz of the Season
• Guest Blog: It's not the county's business to be in the nursing home business
• Yup, Hillary won Texas and Ohio
• Gableman/Butler race featured - and it isn't pretty
• Lies from Planned Parenthood and NARAL
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• The Troha sentencing, Doyle and that $200K
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• Lots of ideas. No money.
• The Cigarette Tax - "Poor Policy Instrument?"
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• Frankenstein - not in the library, but in the legislature
• A librarian, a legislator, a president
• $1.25/pack - NO, NO, NO, and NO
• Kagen and Reagan in the same breath?
• Menasha: behind the 8-ball, but not biting the dust
• Any way you slice it, Wisconsin government wants (further) in on health care
• The World is Flat...what about health care?
• The PAC - too precious to fail. Day 3
• News follow-ups: Appleton West, Kagen at the White House
• Fox Cities PAC - too precious to fail - Day 2
• Fox Cities PAC - too precious to fail
• New Transit Tax coming your way
• Rep. Petri has his finger in the dike - I guess
• AASD Retirement Costs Burdensome
• Health care, health care, health care, health care
• Water rate increase was no slam dunk
• Education for all is just a bad dream
• New Year's resolutions from a parade snob
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