October 20, 2005

Step in the right direction...

This is a very good step. The Great Lesson of the Twentieth Century (well, actually, there were several lessons, but this one is not unimportant) is that "defined-benefit" plans of all sorts are time-bombs waiting to explode...
New York Times. WASHINGTON, Oct. 19 - The Bush administration approved a sweeping Medicaid plan for Florida on Wednesday that limits spending for many of the 2.2 million beneficiaries there and gives private health plans new freedom to limit benefits.

The Florida program, likely to be a model for many other states, shifts from the traditional Medicaid "defined benefit" plan to a "defined contribution" plan, under which the state sets a ceiling on spending for each recipient....

...Under the waiver, Florida will establish "a maximum per year benefit limit" for each recipient and fundamentally change its role. The state will largely be a buyer rather than a manager of health care.

In an interview, Alan M. Levine, secretary of the Florida Agency for Health Care Administration, estimated that no more than 5 percent of Medicaid recipients would hit their annual limits. At that point, Mr. Levine said, "the health plan will still be responsible for providing services to the consumer, but the state's reimbursement would be limited to that amount."

Asked whether the beneficiary would be responsible for paying costs beyond the limit, he said: "That can happen today. There are arbitrary limits and caps embedded in the state Medicaid program, limits on home health services, doctors' visits, prescription drugs."

For each beneficiary, Florida will pay a monthly premium to a private plan. Insurance plans will be allowed to limit "the amount, duration and scope" of services in ways that current law does not permit....(Thanks to Orrin)
I mentioned here that I judge the Bush Administration on somewhat different criteria than many conservatives... "But the metric I'm watching is the Ownership Society (and the war of course)..." This article is an example of what I'm looking for. It's a big step in the right direction. There's a lot of choice involved, and opportunities for people to take personal responsibility. And it gets government out of the business of micro-managing health care...
...The Florida program includes these features, approved Wednesday by the federal government:

¶If a recipient does not choose a private plan, the person will be automatically enrolled in one that the state selects.

¶Medicaid recipients can "opt out" of Medicaid altogether and receive subsidies to help pay the employee's share of the premium for employer-sponsored health insurance. Those beneficiaries will have to pay co-payments and deductibles like other employees in the same plan, even if the charges exceed normal Medicaid limits.

¶The state will deposit money into individual accounts for recipients who enroll in programs to help lose weight, stop smoking and lead healthier lives.

¶Florida and the federal government will establish a pool of money providing up to $1 billion a year to help hospitals and other health care providers who treat large numbers of uninsured people.

A spokeswoman for Mr. Leavitt, Christina Pearson, said the decision on the Florida plan was not influenced by the fact that Governor Bush is the president's brother. Federal officials are prepared to approve similar innovative solutions from other states, Ms. Pearson said.

Medicaid provides health insurance to more than 50 million low-income people. The states and federal government jointly finance it.
Posted by John Weidner at October 20, 2005 9:12 AM
Weblog by John Weidner