Report fails to find cure for Medicaid

Missouri's new Medicaid Reform Commission is considering a draft report today that will make recommendations on Medicaid changes in our state. At the core of their recommendations is the single issue this newspaper has so long-discussed - personal responsibility. But as we have preached for years, it's impossible to mandate personal responsibility. That doesn't mean you don't try however.

One way to change Medicaid behavior, for example, would be this. If a Medicaid patient comes to an emergency room with symptoms that are not really an emergency, they would be directed to a less-costly provider like a doctor's office. That way, the report says, the patient would be held more accountable for controlling their Medicaid costs.

The report also recommends a tiered-level co-payment plan as an incentive for Medicaid patients to put more thought into where they go for their medical needs. The report, in my opinion, also has some useless recommendations like "health coaches" and self-guide charts for Medicaid patients. I believe these last two recommendations are a major waste of time.

Medicaid patients spend substantial amounts of time in hospital emergency rooms, often because they lack a personal physician. The costs for the emergency room service is then passed on to other patients and everyone's health care expenses skyrocket. But there is no incentive to change that behavior, as the report notes.

As expected, Democratic spokesmen quickly criticized the report. They want more Missourians to be added to the Medicaid rolls and they oppose any co-

payment plan. What they don't discuss is how our state will pay for these added services.

One leading Democrat wants employers held more responsible for providing health care coverage. But what the politician doesn't address is that employers will be forced to reduce their workforce if they are required to increase their health care coverage. That means a loss of jobs which puts an even greater burden on the remainder of taxpayers.

We applaud any report that puts a premium on personal responsibility. Now finding a way to implement that recommendation will be the challenge.