My colleague David Gratzer writes in Politico that President Obama, in attempting fiscal restraint, “should start by championing one [idea] that House Budget Chairman Paul Ryan (R-Wis.) is promoting: Reform Medicaid by turning it over to the states.”
That is, instead of Washington matching states’ spending on Medicaid, often more than dollar for dollar, Washington would give each state a set amount of money each year, increased by population and inflation (and maybe some other metrics, like age of population). Then, states would have the motivation to be efficient without hurting care, rather than be as inefficient as possible to wring more federal dollars.
I agree that Medicaid is the best place to start — and I think it’s a far better place to start than Medicare. (Remember, Medicare is for elderly people; Medicaid is (mostly) for poor and working-class people who don’t have private insurance, plus elderly people who receive nursing care.)
Much of the commentary