Skip to comments.In Texas, a surprising Perry plan for Medicaid reform (Surprise! Surprise! Surprise!)
Posted on 11/19/2011 12:17:32 PM PST by Cincinatus' Wife
Its a perennial complaint from Texas Gov. Rick Perry: The federal government places far too many restrictions on how states can run Medicaid, the entitlement program that provides health care to low-income Americans. We know for a fact that, given that freedom, the states can do a better job of delivering health care, Perry said in a Republican debate last month. Hes endorsed turning the entitlement program into a block grant and flirted with having Texas drop out of it altogether.
But back in Texas, Perry is actually pursuing a highly technocratic and pragmatic attempt at Medicaid reform that doesnt much resemble the policy hes floated in his presidential run. He is currently negotiating a waiver with the Obama administration that would net the state increased Medicaid funding if providers could hit certain performance metrics agreed to by the federal government. Its an approach that has pleased just about everyone involved, from Medicaid advocates to major hospitals.
As an advocate, if this is done reasonably well, it could be requiring more from hospitals for what theyre doing, says Anne Dunkelberg of the Center for Public Policy Priorities. It wouldnt just be a cash cow. Hospitals would have to deliver care to the uninsured and have to participate in some payment and delivery reforms.
......But from hospitals to Medicaid advocates, theres a surprisingly high level of agreement on what the waiver would do: bring in more Medicaid dollars to Texas. As for Perry, it shows a political side rarely seen in his presidential debate performances: pragmatic and technocratic, a leader who can craft a deal that brings together just about every disparate health-care interest in the Lone Star State.
(Excerpt) Read more at washingtonpost.com ...
Richard Fisher, president of the Dallas Federal Reserve Board, told me that if you look at the number of jobs created since the recession technically ended in June 2009, Texas has accounted for 48 percent of net new jobs created in the U.S.
Fisher also disparages claims that the jobs are all low-paying jobs at McDonalds or Walmart, paying the minimum wage, or that they were primarily caused by the oil and natural gas boom. According to Tom Pauken of the Texas Work Force Commission, the annual median wage in Texas in 2010 for all occupations was $31,500 a year, only 7 percent below the national average. That difference is easily explained by the fact that Texas has a younger workforce than most states and a higher percentage of workers in lower-pay agriculture jobs near the border with Mexico. [ CW: Cost of living in Texas is lower than many other states; Texas has no state income tax; Texas is a right to work state.]
As for where the job growth has been, three sectors of the economy have grown faster than the energy sector, which alone added 40,500 net new jobs in 2010. Last year, Texas added 57,900 new jobs in trade, transportation, and utilities; a total of 53,400 jobs in professional and business services; and 44,900 net new jobs in the hospitality industry.
For each of the past seven years, CEOs polled by Chief Executive magazine have rated Texas first in the nation for economic development climate and job growth. What is the secret of Texass success? Rick Perry isnt shy about his answer. Its all about four points, he told me. First, dont spend all the money. Keep the taxes low and under control. Have regulations that are fair and predictable so business owners know what to expect from one quarter to the next. And reform the legal system so that frivolous lawsuits dont paralyze employers who are trying to create real wealth.
If there is on issue which Perry has made a personal crusade, it is lawsuit reform. Working with the legislature, he has helped pass curbs on frivolous lawsuits, implemented a first-in-the-nation system under which loser pays all court costs in many lawsuits, and reformed medical malpractice law.
Dick Weekley, the co-founder of Texans for Lawsuit Reform, says Perry showed genuine political courage in resisting calls for watered-down reforms that wouldnt have addressed the core problem. He recalls that in 2002 Perry vetoed a bill strongly supported by doctors that would have required them to prompt payment from health maintenance organizations. In the eyes of the tort reform advocates, the bill was a Trojan Horse compromise negotiated between doctors and trial lawyers. There was a huge response from physicians [against the veto], Kim Ross, the former top lobbyist for the Texas Medical Association, said. TMA went so far as to endorse Tony Sanchez, Perrys millionaire Democratic opponent in the 2002 election. Perry sent a signal that he wanted real reform and would stand his ground, Weekley told me. Soon the medical lobbyists playing footsie with the trial lawyers were gone and the obstacles to real reform started falling. ..
AND now the TMA is endorsing Gov. Rick Perry. They understand now what he was doing would HELP them.
...."The Texas Medical Associations political action committee recently endorsed him for president, and its members are helping him raise money and make connections with medical groups in other states.".... source
"With the signature of Gov. Rick Perry today, Texas has joined three other states stating their intention to enter into a health care compact.
The compact, which would challenge the authority of the federal government to dictate the terms of the federally and state funded Medicaid program, was part of a wide-ranging health care reform bill, Senate Bill 7, passed by the Texas Legislature in its recently concluded special session.
Georgia, Oklahoma and Missouri have already signed onto the compacts movement, with Missouri Gov. Jay Nixon signing a bill into law on Thursday.
The law establishes Texas, along with the other three states, as pioneers in an uncharted use of Article 1, Section 10 of the Constitution which allows states to enter into agreements that, with the approval of Congress, cannot be abridged by the federal government. There are more than 200 state compacts currently in effect, nearly all of them related to commerce. ..
MEANWHILE MITT ROMNEY is pushing these health care exchanges
July 16, 2011: Romney Adviser Backs Obama Health Exchanges
SALT LAKE CITY Former Utah Gov. Mike Leavitt, a top supporter and adviser of Republican White House hopeful Mitt Romney, strenuously backed the core piece of President Barack Obamas health-care law and urged the states to move forward together in adopting health insurance exchanges.
Speaking to a bipartisan group of governors at the National Governors Association, the former Republican governor who served as secretary of health and human services in the Bush administration, called the exchanges where individuals and small businesses can purchase health plans a very practical solution to a problem that needs to be solved. He warned governors who are reluctant to move forward with their state-level exchanges that their intransigence will only empower federal regulators.
Perhaps, but the states shouldn't be involved, anyway. It's always going to be more efficient and better if it's doctor/patient and no one else.
Let’s get it away from the Feds and keep moving it back to the people.
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“Hospitals would have to deliver care to the uninsured and have to participate in some payment and delivery reforms.”
If my husband paid the hospital to let him work there, would that help?
After being Gov for 11 years, I am surprised that he is bringing this up now.....no I am not. He sure is brining up a lot of good ideas now that he is running for President. Had he been bringing these things up while governor and getting them implemented, he might have a fighting chance at being the nominee. Perhaps if he takes these Ideas and works on them the next four years, he can come back for 2016 and have a better chance. He will only be 64 going on 65. He has plenty of time to run again. Too bad he didn’t think about running around 2009 and implementing some of these ideas even then would have helped.
All I know is this: I’ve been without healthcare insurance since 2009. I pay a flat rate to my doctor for visits and out of pocket for meds. In that time, I’ve spent less than I would have with premiums and co-pays.
You know, you never have anything good to say about Gov. Perry and work so hard to leave a bad impression. He has done a lot for Texas— he’s battling the Feds on many issues— the state economy is booming despite Obama — have you bothered to take note? (and I have linked and quoted and given information to you countless times to the point I’m insulted for doing it).
Who is your candidate that you are trying so hard to get elected by repeatedly slamming Gov. Rick Perry, a strong fiscal and social conservative?
You’re right of course. He’s only been elected Governor of Texas 3 times...more than any other Texan...because in all that vast state there simply isn’t anyone else to do the job.
No argument there, but having a government entity involved, federal, state, or otherwise.....it’s problematic. Implemetation of a government plan invites corruption and poor care.
Nov 19, 2011: Since tickets have sold out, please join the Thanksgiving Family Forum streaming live from 3:30-6:00 PM CST: Here
“I pay a flat rate to my doctor for visits”
We have health care coverage, but I still payed cash to the Doc I was seeing, thus paying 1/3 the normal charge.
The Doc appreciated the cash and savings in bookwork.
I like doing things that way.
The Current FReepathon Pays For The Current Quarters Expenses?
How do you square your comment:
“Lets get it away from the Feds and keep moving it back to the people.”
with the stated purpose of Perry’s proposal:
“theres a surprisingly high level of agreement on what the waiver would do: bring in more Medicaid dollars to Texas.”
Not only is government best when it governs least, it governs best when its closest to the people.
Call this, roundabout federalism. Rick Perry gets it.
That is not exactly getting the FedMob out of it. That is still playing by their rules.
lol. I was giving the guy advice. Well it is up to him. I am for Cain, Bachmann or Santorum. Any of these three are incredibly more conservative than moderately conservative Perry, Romney, or Newt. This is our best opportunity to really get a conservative into the White House. Cain is 100 percent conservative, Bachmann is 100 percent conservative and Santorum is 100 percent conservative. Romney is about 30 percent conservative. Newt is about 40 percent conservative and Perry is about 45 percent conservative. Perry supports illegal aliens which is why I will NEVER support him even if he is the nominee. I can’t. I cannot put my opportunity to go to Heaven in place of politics. It just won’t happen. Perry supports people who break the law. That is unacceptable.