Streams

Cuomo's Medicaid Medicine Going Down Pretty Well

Thursday, March 31, 2011

Doctors and patient (Seattle Municipal Archives/flickr)

Welcome to Politics Bites, where every afternoon at It's A Free Country, we bring you the unmissable quotes from the morning's political conversations on WNYC. Today on the Brian Lehrer Show, Jim Tallon, president of the United Hospital Fund, talked about the new budget agreement and its effect on New York's healthcare.

A spoon full of sugar helps the medicine go down, right?

Cuomo's axe to the New York Medicaid budget of almost three billion dollars raised few cries of pain among the state's health care industry--but where was the sugar? 

James Tallon says it wasn't about a tradeoff this year, it was simply a medicinal dose of reality.

Folks in healthcare in New York recognized also that outside of New York there is also a conservative extreme in American politics that really wants to dismantle our governmental programs, so candidly, while there were big cuts in New York, if you look at the glass half full, this was Democrats, Republicans, Governor and legislature coming together essentially to affirm a modified, a reduced but nonetheless a very comprehensive fifty billion dollar Medicaid program in New York.

Tallon said Republicans in the House of Representatives and in over 20 states want to simply get people off the Medicaid rolls to save costs. Their plan is to reduce eligibility for the program or get rid of it altogether, which Cuomo did not do. In that sense, Tallon said the Governor's approach affirmed his commitment to the program, even as he pushed people in the industry to make it more efficient--which they are willing to do.

Consensus that something had to change in the health care system

People in health care know that there's room for better management of care, in fact that is the fundamental underlying theme of the federal Affordable Care Act, the health care reform bill passed in Washington.

The difficult part is that costs are concentrated in persons who have complex health care needs and the current health care system doesn't make it easy to treat complicated cases comprehensively. 75 percent of New York Medicaid funding--or 31 billion dollars--is spent on just 20 percent of patients.

These are patients with multiple chronic illness, sometimes there is mental illness, behavioral health problems associated with physical concerns, some people are in the long term care system, they're eligible for the Medicaid and Medicare system, that's an added complication.

Tough medicine, but necessary

Cuomo made it clear there wasn't going to be an influx of any additional money to the system, so there was consensus something had to give. Tallon said the fact that Cuomo brought Medical and health care industry professionals into the discussion of how to improve the system (the Medicaid redesign team) was helpful.

Everyone in health care said look, there's room to better manage this, not that it will be easy. The tough and challenging fact is that we don't have a lot of experience, the commercial insurance industry largely doesn't deal with folks who have these more complicated problems.

Will the Medicaid cuts actually make New York State healthier? Hard to know, but it's a new regimen. 

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Comments [4]

Jenny Snider from New York City

New proposed Medicaid guidelines, reported last week on WNYC, are yet another example of short-term, short-sighted and down-right wrong-thinking in the BUDGET PROCESS. They describe a new requirement for those applying for Home Health Aides under Medicaid: a client needing Home Health Aides, after going through the bureaucratic nightmare of the Medicaid application process, must now VISIT and get written approval from a doctor, most of whom, unlike some veterinarians in New York City, do not make house calls. (One of the many duties of a Home Health Aide is to take the elderly and the infirm to their medical appointments.)
As with many of your "BUDGET REFORMS” and “BELT-TIGHTENING MEASURES," this one does nothing to eliminate waste and corruption; certainly not by adding yet another layer of paper-work, time, energy and bureaucracy onto an already Kafkaesque application procedure.
The unspoken assumption in talk about waste and corruption, (formerly limited to Republicans,) is that the biggest abusers of the system are the consumers of Medicaid services. As the daughter of a women who spent most of her working life as a Civil Servant in New York City, and the last year of her life on Medicaid, I believe the biggest problems of abuse occur because of poorly staffed administrations, and poorly trained and supervised administrators. The losers are always the taxpayers and the Medicaid recipients.
I continue to be appalled by the hypocrisy of our elected officials who have yet to tighten the belts of those who can and should afford to do so.

Apr. 02 2011 02:59 PM
joe gerardi from long island

i am the parent of one of the people with developmental disability who benefits from nys committment to this population---
we cannot go backwards in our policies regarding these individuals---we then make years of special education a waste of time and money and risk having thousands of people who can be contributing to our communities be wasting
away in custodial care ( or on their parents sofa )--these $ are invested not just spent

Mar. 31 2011 11:17 AM
Susan from NYC

Is it true that NY has half the population of CA but vastly higher Medicaid costs? If so, does anyone know why?

Mar. 31 2011 10:44 AM
John Steme from nyc

The health care providers steal SOOOOOO much money from us.....

Mar. 31 2011 10:43 AM

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