Restraining Medicaid at whose expense? | Arkansas Blog

Sunday, December 11, 2011

Restraining Medicaid at whose expense?

Posted By on Sun, Dec 11, 2011 at 8:28 AM

Interesting story today from John Lyon of Stephens Media on a Beebe administration proposal to rein in Medicaid costs by establishing service centers to handle developmentally disabled people supported by Medicaid-financed programs.

Parents are worried. Sure. If you reduce costs — or merely restrain the growth in costs — something has to give. Somebody — care provider or agency — is going to get less money. Few believe more services will be the result. It is sort of another version of the "death panel" argument. And it repeats the famous TEFRA battle of the Huckabee years, the program by which even wealthy people could qualify for expensive government support for children with disabilities. They were loathe to give it up, naturallly, and raised such a ruckus that Gov. Huckabee backed off the changes. You hear echoes of that debate in the current issue.

Cheryl Adkisson of Alma, who has a 15-year-old daughter with Down syndrome and an 11-year-old son with autism, said she does not like the thought of taking her children to be assessed at a service center.

“They can decide that my child, because they’re relatively ambulatory and their motor skills are sufficient that they can get around, that they don’t need physical therapy — there goes that service,” Adkisson said.

“They can decide that because my child has a speech delay and he’s had speech therapy for the past 10 years, he’s obviously not going to get better, there’s nothing more we can do — there goes the speech therapy,” she said.
Adkisson said the state should look for ways to cut administrative costs and leave services alone.

Realistically, you can't operate programs without administrative costs. Realistically, less money means less service. Realistically, there might be times when less government service and expense makes practical and rational sense. But just try telling that to the parent of a disabled child or to family members of a terminally ill elderly person whose life could be extended, however briefly, by heroic and expensive government-paid medical services.

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