Pay Attention

George Winner

September 24, 2010

It pays to pay attention.  That’s always great advice, but it sure isn’t advice that New York State has taken to heart when it comes to the cost of its Medicaid system.

In fact, New York leaders are being told a billion times a week that Medicaid is out of control and consuming state taxpayer dollars at an unsustainable pace.  Yet too often it just looks and sounds like not enough people are paying attention.  I say a billion times a week because that’s how much the system is costing taxpayers.  Medicaid costs approximately $52-billion-a-year in New York, or a billion dollars a week.

I’m returning to this topic now because there’s another opportunity for New Yorkers, including state leaders, to pay attention.  Last week New York Lieutenant Governor Richard Ravitch issued a new report that stands as the latest call to reform Medicaid.  According to Mr. Ravitch, who enjoys widespread respect as an expert in government finance, “Spending for New York’s Medicaid program is more than $50 billion per year, and the program is expected to grow still more in the coming years with the implementation of federal health care reform.  But the current State budget crisis is threatening New York’s ability to handle the growth of this program without dramatically raising taxes or cutting other essential government services.”

Getting directly to the point, the new analysis states that for “reasons of history, bureaucratic inertia, and politics, New York’s Medicaid program is not administered in the most rational or cost-effective manner.”  And that, as they say, is a classic understatement.  In fact, Medicaid is one of the state’s most abused, wasteful, and over utilized programs.  You can view the full report here.

So let’s pay attention as the fall election season roars into view.  It’s always a difficult time to stay focused on what’s important, and what’s not.  But here in New York State, let’s hope that Medicaid reform gets the attention it deserves, because if state government doesn’t finally get serious about controlling Medicaid costs, it simply won’t be able to get serious about cutting taxes or freeing up additional resources for priorities like economic growth.

We haven’t shied away in this region from scrutinizing (and shouting about) Medicaid.  I’ve been talking about it and sponsoring legislation to try to fix it throughout my tenure in the Legislature.  Local officials, led by Chemung County Executive Tom Santulli, have been out front on numerous initiatives that have made a difference.

Still, the issue keeps hanging out there, unsettled and unresolved.  It simply has to be a top-of-the-ticket concern in the next session of the Legislature.

I’ve been hearing the public’s message on state spending throughout the past year.  I’ve received letters and e-mails virtually every single day, including this one from several months ago that I’ve used as an example since then to characterize what people are thinking, “Run the state like we run our households.  If we can’t afford a Mercedes, then we buy a Chevy, or we don’t buy at all.  The state must start living within its allotted budget.”

New York has a system of Medicaid that many consider a Mercedes.  If we’re paying attention, we’ll be looking long and hard at a trade-in – not to something that won’t run just as well, but to a system that’s more cost-effective, efficient, smarter, less wasteful, and that ultimately makes more sense for more New Yorkers.  


Earlier this year the Senate Republican Task Force on Medicaid Fraud, on which I served as a member, also issued a report and a series of recommendations -- read more on that effort here.