Medicaid Mess

So Fletcher got through an agenda with minor tax increases, tax relief and a slightly smaller government. Not bad, but why, I wondered, could he not have reduced the size of government in a major way, cutting the need for as much revenue, and thus get through a budget with no tax increase at all?

"Because we have 695,000 Kentuckians on Medicaid [roughly 75,000 more than children in K-12 schools]," he replied without hesitation. He cited what is increasingly the premier reason states say they are operating in the red. "Each state has different problems with Medicaid and the one-size-fits-all approach isn't working. With pharmaceutical and health care costs going up the way they are, the time will come quite soon that we won't be able to pay for the antiquated system."

Fletcher doesn't have the solution for the mounting Medicaid crisis, not yet anyway, and there will have to be major statutory changes in the program at the federal level to give' states the flexibility to come up with fresh solutions, he says.

"But, we need to get waivers to start experimenting with possible solutions," he told me. "It's just like welfare a decade ago. We need pilot programs, and we need the states to experiment. With 50 different laboratories, we'll find the solution."

Copyright Human Events Publishing, Inc. May 16, 2005
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