I buried the lede in my post yesterday so in case you missed it, Gov. Easley said the three
biggest parts of the state budget are corrections, education, and
Medicaid. “You can’t let out a lot of prisoners, and you can’t cut the
classrooms, certainly not in this economy, so that leaves health care.”

Tennessee Gov. Phil Bredesen explained the problem with TennCare and
all Medicaid programs–there is no money. Medicaid is a “great
enterprise,” he said. “All great enterprises are powered by the heart
but they are steered by the head.” Steering by the head means applying
“common sense economics and common sense management techniques.”
Tennessee is near the bottom among all states on a number of indicators
including infant mortality, low birthweights, and others. Even after a
decade of one of the most expensive and expansive Medicaid programs,
“We have not moved those indicators one notch in that time.”
His principles for all health care spending and Medicaid in particular
are to make sure everybody pays something for everything they use and
that “we become purchasers instead of just payers,” looking at what
we’re getting for our money.

Ron Pollack of FamiliesUSA complained that federal Medicaid spending
adjustments will mean $1.4 billion less money for North Carolina over
the next ten years- – less than one-tenth of additional spending over that time at a modest 3% annual increase.

Rep. Mel Watt said nothing after a long meandering trip through
the Congressional Black Caucus’ visit with the President. Elizabeth
Docteur of the OECD showed the US spends as much government money on
healthcare as other countries but spends a lot more private funds–the
US is also the only country without a single payer system and the place
where many others come to make sure they receive treatment.