Shifting The Costs And Ducking The Blame

July 21, 2003
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In its efforts to balance the state budget, the Granholm Administration has proposed capping hospital admission reimbursement for adult Medicaid patients at $900.

Reportedly, that’s just about enough to cover the administrative cost of admitting a patient, turning back the sheets and furnishing an emesis basin.

And as far as Lansing is concerned, the rest of indigent patients’ costs — physician’s rounds, blood tests, X-rays, lab work, nursing, IVs, therapy, medicines, CAT scans or MRIs and perhaps surgery — should be somebody else’s problem.

Hospitals indicate the $900 cap would force them to transfer un-reimbursed costs to other patients. Those costs ultimately would ratchet up group health premiums shared by private employers and employees, and hike those employees’ co-pays and deductibles.

Bluntly, Lansing is trying to levy a stealth tax to finance hospital care for the indigent.

What is so politically neat is that while the private sector surely would feel this new increment in health care costs, most people actually paying higher premiums, co-pays and deductibles would blame the usual suspects: greedy hospitals, greedy doctors, greedy lab techs, greedy nurses, yada, yada, yada.

Lansing would take no heat.

The Granholm administration certainly did not invent this kind of chicanery. The Williams, Milliken, Blanchard and Engler administrations tapped out their own versions of the same dance.

But the sad thing is that across the board, no Lansing administration — Democrat or Republican — ever has attempted to impose similar sacrifices upon Michigan’s civil servants. Such an act would have no stealth and would provoke public employee union fury.

Now to be sure, the state’s 55,600 employees pay their fair share of sales, income and property taxes.

But no Lansing administration has subjected the State of Michigan work force to anything remotely resembling the layoffs or the downsizing that tough times have inflicted on the private sector. Neither have there been increases in workers’ shares of health insurance premiums remotely approaching what has happened in private sector health insurance.

If the state’s own Web site data are to be believed, a Michigan employee pays about $18 every two weeks for full-family Blue Cross Blue Shield coverage. The taxpayer’s share of that premium is $347. Oh, it’s great coverage. It features an individual $200 deductible — the same sort of platinum-plated coverage that teachers’ union members have.

State workers certainly have not had to fork over anything like the private sector’s $20 and $25 co-pays for office visits and prescription drugs (for those groups, that is, fortunate enough to have prescription coverage).

But that’s not entirely true. Speaker of the House Rick Johnson recently ordered a sharp cut in the annual allotment — that’s right, allotment — House members receive to pay for their health insurance. He also ordered state representatives’ prescription co-pays doubled from $5 to $10.

How long has it been since the $10 co-pay and the $200 deductible disappeared from private sector group health insurance?

The action by the House speaker — to force the people’s representatives to pick up a slightly larger share of the health care burden — certainly is a very, very modest lead.

The governor should strongly consider following that lead.

The private sector already is pulling more than its own weight.

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