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As I See It

Medicaid solution is really quite simple

Sometime in 1970, my father and I were discussing the welfare state into which the U.S. was then rapidly sliding, or so it seemed anyway. I was attending graduate school at Southern Miss and, as with most graduate students, had drifted somewhat left of center.

My father said that the country should do away with welfare altogether and stop making dependents out of poor, working people.

I gasped and argued that poor folks would starve to death by the droves if welfare were suddenly stopped.

With am incredulous look that had “stupid” written all over it, he told me to call Wright and Ferguson Funeral Home and see when they last buried anybody who starved to death. His point, somewhat harsh but true, was that welfare was a fairly new program in 1970 and nobody had starved to death before it started.

The net got too big

“Welfare as we know it” did begin phasing out in 1996 and the predicted calamity of mass starvation did not occur. In fact, quite the opposite actually happened.

Now, here in Mississippi and throughout the country, obesity is a more serious problem than starvation. This is not to say that our society doesn’t really include some needy folks. It does. There have always been needy folks and there always will be and a rich country like the U.S. is morally bound to provide a safety net for the direst situations. It’s just that the safety net got too big and living on the public dole got too comfortable for too many people.

Unfortunately, the same thing has happened again with Medicaid. With 25% of all Mississippians qualifying for Medicaid, the net is too big and taxpayer funded healthcare costs has gotten too comfortable for too many people. It’s unreasonable to ask taxpayers to shoulder the healthcare cost for one of every four people in our state. It’s not necessary and we aren’t gonna do it!

The harsh reality is that the qualification bar for Medicaid has got to be raised. It’s not going to be popular or easy.

Horror stories of granny eating dog food so she can buy her meds will abound and, in some cases, it will be true. In most cases, however, family members will simply have to forego some biggie-sized Wendy’s burgers occasionally and help out with the drug cost.

Families have always helped take care of each other and that is the solution for those who really don’t deserve public assistance. Chicken Little will be live and well but the sky really won’t fall and Wright and Ferguson Funeral Home really won’t start burying people who starved from eating a diet of pure Celebrex.

Politicians should be ashamed for getting us into this mess, but they aren’t. They brought the state to its financial knees promising benefits that we can’t afford just to keep getting themselves re-elected to the Legislature.

When will we learn? Or will we?

Will we ever learn that government should only provide the minimum services that citizens can’t provide for themselves and leave everything else alone?

I suppose the lure of creating a dependency of loyal supporters is just too powerful.

What can be done?

There really are two choices: either raise taxes or cut spending. Raiding the highway fund is no longer an option since that fund was looted last year. Raising the tax on cigarettes is a good start, but if we raise it above what is collected in neighboring states we’ll merely create a black market and make our state a haven for hoodlums. We can attempt to raise taxes, though Gov. Haley Barbour has vowed to veto any tax increase.

It really doesn’t look good for raising revenue much. Placing the $20-million tobacco education fund in the hands of the rightful owners, the taxpayers, would certainly help — not only because $20 million is a lot, but because federal matching funds would turn it into many millions more.
How about cutting spending?

Now we’re getting somewhere. Any attempt to cut spending without addressing the runaway cost of Medicaid will fail. Postponing the final phase of the teacher pay raise will make liars out of us all; however, consolidating school districts would save lots of money and harm no one beyond bruising a few egos. We can tinker with this little cut and that little cut, but I really think an across the board cut for all agencies plus getting Medicaid under control is what it’s going to take.

Now, the way to fix the Medicaid situation is really quite simple. Figure out what percentage of the poverty level income produces a Medicaid cost that we can pay and change the formula.

The Legislature needs to be strong and honest and admit that they’ve made a mistake and, for the good of the state, they’re going to correct the error.

Many will not be returned to the Legislature after the next election but perhaps that is a just reward for playing politics with the public purse.

Thought for the Moment

Make it your ambition to lead a quiet life, to mind your own business and to work with your hands, just as we told you, so that your daily life may win the respect of outsiders and so that you will not be dependent on anybody. — 1 Thessalonians 4:11

Joe D. Jones, CPA, is publisher of the Mississippi Business Journal. Contact him at cpajones@msbusiness.com.

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