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Bad health care news, but a good example to follow

Give people some responsibility and they might be stakeholders.

Friday, August 27, 2010 - 10:32 am

Here's the bad news on Indiana health care costs: Gov. Mitch Daniels has decided to formally ask for the $227 million extra in “stimulus” funding from the federal government to bolster Medicaid, giving in to President Obama's nifty little political stunt. Better to look like a hypocrite for also having criticized such funding, apparently, than to appear indifferent to the state's poorest sick.

And here's the worse news: Indiana's human services director, Anne Murphy, and insurance commissioner, Stephen Robertson, are warning Daniels that the ObamaCare health care overhaul will cost Indiana at least $3.6 billion over the next 10 years and possibly as much as $3.8 billion. That's up $235 million from the previous estimate in May.

It doesn't take a mathematical genius to figure out that something has to give. If sane, fiscally responsible legislators don't find a way to kill or drastically scale back ObamaCare, states like Indiana are going to go broke or have to pass economically devastating taxes.

In the event there is no miracle, Hoosier leaders need to begin thinking of ways to make savings in Medicaid. They could do worse than study the example of Wisconsin – in this “laboratory of democracy” known as federalism, we are obligated to study the successfu

l experiments.

Faced with a projected $6.6 billion deficit, the largest in state history, Gov. Jim Doyle and the legislature proposed cuts of up to $635 million for Medicaid, about 10 percent of Wisconsin's total for the joint federal-state program. There's no way to make such drastic cuts without making almost everyone unhappy, so Wisconsin tried a novel approach.

The agency overseeing Medicaid was given the dollar amount to cut, but it had the authority to decide how and where to cut. There followed a remarkable six-month process in which insurance companies and Medicaid providers met with advocates and academics. State health officials just refereed the discussions. At the end of the process, the savings goal was reached, but that wasn't all – coverage was expanded to include 41,000 childless adults.

Most surprising, the reaction to the huge cuts was largely positive from all involved, patients, advocates and providers alike. Give “stakeholders” the responsibility to make choices, and they might live up to that term.

The federal government is probably beyond learning that lesson, but we should still be educable in Indiana.