Alarmed by rising health- care costs, Gov. Mark Sanford pushed for, and received, permission to make drastic changes to the Medicaid system. Among the changes are that patients will be expected to make a co-payment before receiving treatment for non-emergency maladies at emergency rooms.

The overhaul, which will be implemented first on a pilot basis, is designed to encourage Medicaid patients to exert more control of their own health. It offers them choices among several types of plans, including some that resemble employer health plans, and offers incentives for using generic drugs.

A plan to issue Medicaid clients a debit card was dropped. In theory, it would have given patients even more control over treatment plans, but critics said it would discourage participants from seeking care when they were truly ill, or perhaps some would spend their allotment on nonessential needs, only to be left without money when a more serious threat arose.

We hope state and federal officials will scrutinize this program. Horror stories arising from the new Medicare prescription drug program show that radical changes in health-care delivery can result in widespread confusion. Unless Medicaid clients are educated about how these changes will affect them, a lot of people likely may suffer unnecessarily.

IN SUMMARY
South Carolina soon will launch a pilot program to reform the way Medicaid patients are treated. Education of clients -- and health-care providers -- will be essential.