Medicaid: That GIANT sucking sound

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36aa246Roy Cooper sees the expansion of Medicaid as a “job creation” tool.  In 1992, Ross Perot talked about that giant sucking sound produced from NAFTA taking all our jobs to Mexico.  In 2016, Medicaid is the giant sucking sound stifling economic growth in our state and trapping even more people in a state of dependence.  Here’s an interesting take on our Medicaid system: 

The popular image of Medicaid is that of a small program that provides basic but good-quality medical care to a limited, impoverished segment of North Carolina’s population – and that politicians have skimped on funding it. The reality is different.

  • A small program? Try this experiment: Walk down the street and think of every fifth person as a Medicaid recipient. That’s because nearly one in five North Carolinians is enrolled in the program.
  • Limited? Imagine that over eight years one city the size of Greensboro and another the size of Durham were added to North Carolina. Well, that’s how many people were addedto the Medicaid rolls in one recent eight-year span.
  • Impoverished? Someone with a $490,000 house, jewelry, a good retirement account, a nice car and a business can still qualify for long-term care under Medicaid.[…] 
  • Medicaid is now the second biggest item in the state budget. At $3.1 billion in state spending for FY 2012-13, Medicaid spending is second only to K-12 public education.[…] 
    • That price tag has shot up by nearly a billion dollars from just a decade ago.That’s an increase of 42 percent
    • .And good care?  Care may be good quality – if you can get it. Poorly designed cost-cutting measures have significantly reduced the availability of care to Medicaid patients. […]

For FY 2012cooper1-2, North Carolina spent $12.2 BILLION on Medicaid.  That’s nearly TWICE what Virginia had budgeted, and THREE TIMES what South Carolina had.  From 2000-2012, North Carolina’s Medicaid enrollment grew  by 76%. THAT was second — among its neighbors — only to Virginia’s 92 percent.   In 2012, Medicaid was 25% of the North Carolina state budget.  That was second only to Tennessee, which had Medicaid as 31% of its budget. In 2012, North Carolina’s Medicaid was buttressed by a 65% match from Washington.  That was third — among its neighbors — behind 70% for South Carolina and 67% for Tennessee.

In 2010, there more than 1.8 million North Carolinians enrolled in Medicaid.  That led ALL of the state’s neighbors, with Tennessee’s 1.5 million and Virginia’s 1.02 million coming in second and third.  In North Carolina, only 27 percent of enrollees were either elderly or disabled.  The remaining 73 percent were “parents and children.”  When you look at payments, as of that year,  62 percent went to elderly and disabled while 38 percent went to “parents and children.”

Here are the mandatory benefits the federal government says HAVE to be provided by Medicaid in each state:

  • Hospital services for inpatients
  • Hospital services for outpatients
  • Health screenings for individuals and children under age 21
  • Nursing facility care
  • Home healthcare
  • Physician checkups and other services
  • Rural health clinic visitsmoneywhirl
  • Visits to federally qualified health centers
  • Laboratory tests and X-rays
  • Family planning
  • Nurse midwife care
  • Maternity and newborn care
  • Visits to pediatric and family nurse practitioners
  • Visits to licensed freestanding birth centers
  • Emergency and non-emergency medical transportation
  • Tobacco cessation programs for pregnant women

Here are the “optional” benefits — above and beyond the federal mandates — that North Carolina’s Medicaid system provides:

  • Freestanding ambulatory surgery centers
  • Public and mental health clinics
  • Certified registered nurse anesthetists
  • Chiropractic care
  • Dental care
  • Dental surgery
  • Optometrists
  • Psychologists
  • Dentures
  • Home medical equipment
  • Prosthetics
  • Adult health screenings
  • Case managementmomoney
  • Home and community-based services
  • Hospice care
  • Personal care
  • Private duty nurse
  • Program of All-Inclusive Care for the Elderly (PACE)
  • Inpatient psychiatric care for individuals under age 21
  • Inpatient care for mental diseases for individuals age 65+
  • Intermediate care for intellectual disabilities

Keep all of this in mind for the next time you hear Chris Fitzsimon or Roy Cooper belly-aching about how we’re *cheap-skating the elderly and disabled.* 

Democrats beat on Pat McCrory for refusing to accept the Medicaid money from DC to implement ObamaCare.  They claimed the money would create an economic boom during some tough economic times.

wimpyThat kind of thinking, like so many other statist schemes, is one big shell game.  Money is being rearranged and passed around.  No wealth is being created.

It’s understandable to want to help the elderly and disabled who simply can’t take care of themselves.  I have some extended family who have struggled for years with caring for a disabled family member.  I know it’s a tough scenario to find yourself in.

But — at the rate we’re going — this program will keep enrolling people and sucking money out of the productive, private side of the economy.  What started as a way to help the really needy folks has been expanded by politicians seeking to create dependency and buy votes.  Dumping even more money into this is not going to “fix” a thing.  Whether the cash comes from DC or Raleigh, it is still being confiscated from the productive class.

The legislature keeps punting on this issue – -thanks to a lot of well-placed and well-timed campaign contributions, I’m sure.  Growing Medicaid is the last thing we need to be doing in North Carolina.  We’ve got to get the mess under control.