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Forced into managed carePosted Friday, October 3, 2003 - 6:09 pm
Medicaid, but lawmakers should go slow on forcing the poor into managed care. Gov. Mark Sanford commendably is demonstrating leadership on the enormously challenging issue of funding health care for poorer South Carolinians. He pledges to push once again for an increase in the cigarette tax when the Legislature reconvenes in January. That tax would provide a stable source of funding for Medicaid, which is facing a multi-million-dollar deficit when $175 million in one-time money expires. Sanford wants to couple the cigarette tax increase with a cut in the state income tax. The income tax cut, however, wouldn't occur until state revenues begin to grow, but money from the cigarette tax increase would be available almost immediately to shore up the state's struggling Medicaid system. Almost 1 million South Carolinians — including the poor, disabled and the elderly — receive some Medicaid assistance. Two huge obstacles loom: Next year will be an election year, and lawmakers will not be in the mood to raise taxes — even the cigarette tax, which has widespread public support. In addition, House Speaker David Wilkins has said the Legislature shouldn't even consider a cigarette-tax increase without first approving comprehensive Medicaid reform to control health care costs. But the Medicaid reform proposed by Wilkins — and approved this session by the House but not the Senate — would force at least 203,000 Medicaid patients into HMOs or another form of managed care. That's a mammoth reform that proved disastrous in Tennessee. Physicians and hospitals, understandably, oppose such a large-scale experimentation with the lives of South Carolinians. They're worried, and with good reason, that managed care would mean that already inadequate Medicaid payments to doctors and hospitals would be sharply reduced. The number of medical services for Medicaid patents could be severely cut. Doctors would be forced to accept fewer Medicaid patients. Medicaid recipients could be left out in the cold. Health providers don't oppose Medicaid reform outright, as indeed they shouldn't. But Medicaid reform aimed at containing costs must be coupled with a decent standard of health care for South Carolina's most vulnerable residents. Sanford and Wilkins should meet in the middle. State leaders should approve a cigarette tax hike and adopt a go-slow position on forcing Medicaid recipients into managed care. |
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Thursday, October 23 Latest news:• Upstate to share in $500,000 federal grant (Updated at 8:57 AM) | ||||
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