Medicaid Boondoggle

Boondoggle is defined as a term for a scheme that wastes time and money, a knotting and plaiting craft known in the U.S. as "boondoggle". All of that defines the Medicaid funding struggle that has been ongoing in Missisippi, and has been particularly wild in the last three years.

This latest (of a year-after-year-after-year) Medicaid funding struggle has concerned me for months, but I've been more than a little weary of having to watch it from the sidelines again and feeling helpless to stop the foolishness - again.

Sometimes one has to ponder whether our illustrious Republican Governor Haley Barbour, in all his ex-Washingtonian splendor and cunning, has gotten so good at manipulating the citizens of this state, that he's come to think of us all as utterly, irretrievably stupid?

Where do we begin to untangle the Machivellian web that Medicaid funding has become? It's never been simple, but in these days, the knot has become more tangled and tightly wound than ever.

Let's not go all the way back to the beginning, but just a little way - back to a short time before Katrina. Medicaid funding had been a struggle up til then, with Barbour threatening to close it down (and nursing homes giving eviction notices to their patients) at one point in 2005. When Katrina hit later that year, Haley began working the federal system, Mississippi received funds from the feds to shore up Medicaid both because of the strain on the system from devastated and destitute folks on the coast, and because of the influx of people fleeing Louisiana for Central and North Mississippi. He worked the federal system with such success that it ensured his reelection and literally saved his political bacon after the fallout from the threatened Medicaid shutdown earlier in the year)

And during the next two years, there was still a struggle going on over a shortfall in Medicaid. The House of Representatives, which is majority Democrat, wanted to raise tobacco taxes to cover it, pointing out that Mississippi has the one of the lowest tobacco taxes in this county (only Missouri is lower, by one cent). They also thought that grocery tax could be reduced (Mississippi, ironically, with one of the lowest tobacco taxes, has the highest grocery taxes in the U.S.). Ex-tobacco lobbyist, now Mississippi Governor Barbour, and the Republican-controlled senate that he uses as a puppet, along with ex-Lt. Gov.
Amy Tuck (strings also pulled by Haley) demurred. Why tax something that's bad for you and will cost the system huge amounts of money in future Medicaid payments for cancer and emphysema treatment when everyone, even the poorest among us, can pay thru purchase of an absolute necessity?

Using a political maneuver that no past Governor, in a state with weak gubernatorial powers, had utiliized, Barbour increased his power over Medicaid funding by blocking the House moves with the Senate (which he controlled) and waiting to call special sessions, where he could set the agenda directly, bypassing the House and Senate committee system. This would never work without a controllable Senate, but Barbour had it and was smart enough to exploit it.

Now, two years forward, 2007, Mississippi lands a coveted prize, the new Toyota plant (we won't even talk about the kind of burden the taxpayer has to shoulder in their incentive package). Our esteemed Governor proposes that we spend $25 Million leftover federal money on improving roads to the Toyota plant, $25 Million which not that many people realize was leftover MEDICAID money. In case you didn't catch that, $25 Million in leftover MEDICAID MONEY. A stink was raised at the time and the idea was either pulled or put on the back burner, although most newspaper stories didn't mention that it was Medicaid money, only that it was leftover Katrina funds. I wouldn't be surprised to see Gov. Barbour wait for the stink to die down, and pull this one back out of his bag of tricks. Now you see it, now you don't.

I'm not sure if that was all the money that was leftover, but at any rate, that would make a sizeable dent in the shortfall. Now, why do we have a Medicaid shortfall if we had left-over Medicaid money? Anyone have an answer that doesn't remind one of the words boondoggle or shell game?

And here we are AGAIN in 2008, dealing with a shortfall, and a Governor who is determined not to let a tobacco tax go thru. His proposal now is to put a huge tax on hospital beds. I'd worry about the hospitals if I didn't know they'd pass the cost on to patients and insurance companies (who will pass it on to their customers). So, in the end, who gets to pay this tax? You and me. Every time we have to pay for insurance, or every time we have to go to the hospital, we'll pay.

Worse, Medicaid will end up paying more for their clients who end up in the hospital, so there is another potential shortfall pending from that. I guess we can deal with THAT shortfall after Barbour is long gone, having left with a smile on his face, satisfied that he, after all, is smarter and faster with his moves, than all us dumb hicks left in his Washington dust.

Get real and get smart, Mississippi, don't fall for the tricks any more - call, or email your represtative and your senator, and tell them to stand up to Mr. D.C., not to gamble our money on Barbour's shell game. I wouldn't even bother contacting the Governor, he doesn't care and he can't run again, so there is no leverage. His old pals from the tobacco companies have all the leverage.

Tax tobacco and plug the shortfall, tax tobacco and plug the long haul. Make it more expensive to smoke and chew; those who give it up because of the expense will cost us less down the road in reduced cancer and emphysema, much of which would end up being paid by Medicaid. That's the only solution that makes sense to anyone but those who were willing to throw our elderly out on the streets in 2005.