Medicaid Reform in Pennsylvania
by: Patrick Ivory, MPAS, PA-C, Immediate Past President
The Pennsylvania Medical Society held a meeting recently in Harrisburg and invited representatives from numerous health care provider services in the Commonwealth to discuss the Medical Assistance program (Medicaid) and what can be done to fix the problems with the program. A briefing was given by Mr. Jim Hardy from the Department of Public Welfare and he outlined changes as a result of the new budget in Pennsylvania. It is evident that the systems demands out weights the available resources provided by the federal government and the additional amounts added by the state. The 2005-2006 fiscal year budget calls for the expenditure of $14.2 million dollars. The state per capita spending for Medicaid has increased 180% between 1990 and 2005 and it is estimated to become a lot worse.
A presentation was made by Mr. Richard Teske who is an independent writer and consultant on political and health care policy. He served as an advisor to the Reagan Administration He is a recognized expert on market oriented Medicare, Medicaid , Long Term Care and Uninsured Reform. In the talk, Mr. Teske indicated that one of the major problems with Medicaid is that it is based on the one size fits all basis. No matter what the reason someone is on Medicaid, the benefits are globally the same. He feels that modifying the system to tailor it to the needs of the recipient would improve the overall functioning of the program. He stated that the development of a market based program which mirrors commercial insurance could be the impetus for change and savings.
There was much discussion on how a program such as this would take preventive care into perspective. Generally, the tone of the comments from the participants did not favor some of his suggestions. Mr. Roger Mecum, Executive Director of PMS, closed the meeting asking that the dialogue remain open and that further meetings be scheduled in the near future with the idea of developing a recommended policy paper to be submitted to the Governor with recommended changes. He asked that the participants take this proposal back to their respective leadership and consider continuing with the discussion and possibly absorb some of the cost of the project.
The PSPA leadership will discuss our participation in the work group. We will consider our role in developing a reform proposal because if we do not participate in the potential change we may find ourselves having to live with a program that is not PA friendly.