Hope! Real Medicare-Medicaid Reforms

Sensible reforms to two budget-busting government health care programs may be possible after all. Hotair.com has an interesting post about the bi-partisan behind-the-scenes discussion—including at least 12 Democratic senators—of the Paul Ryan-Ron Wyden compromise to reform Medicare for seniors.

Promising news, too, on the Medicaid program, which Grace Marie Turner calls "a dismal program that finances care for low-income Americans but condemns them to long waits in emergency rooms to get even routine care." Rhode Island "wrested from the Bush administration a global waiver for the state's Medicaid program" in exchange for an experimental block grant with a five-year spending cap of $12.1 billion.

A December 2011 study by the Lewin Group, a consulting firm, found that Rhode Island's block-grant experiment allowed it to lower spending and improve the quality of care while maintaining the same enrollment levels. Patients had better access to doctors, reducing the need for expensive emergency room use. Costly long-term care patients who don't need to be in nursing homes were switched to home and community-based care, for example. The savings total more than $55 million.

Now several members of Congress "have introduced the State Health Flexibility Act (H.R. 4160) to federal funding for Medicaid and the Children's Health Insurance Program into one block grant to the states."

The legislation would give the states maximum flexibility to tailor the program to meet the unique health care needs of their citizens without having to plead with Washington for every minor improvement they want to make.

Importantly, the legislation meets the seven principles for Medicaid reform proposed by 29 governors in June 2011, and it also requires accountability to taxpayers. Annual audits are required in each state to report to the U.S. Treasury, state legislatures and the public to ensure the federal funding is spent properly.