Friday, August 04, 2006
Tommy Thompson may be misguided
[Christopher Lee, "Ex-health chief offers new Medicaid plan," The Boston Globe, 4 August 2006.]
It's still too early to say for sure if Tommy Thompson's proposal to overhaul Medicaid suffers from a case of over-centralization, but early indicators suggest that's likely the case:
The former Wisconsin governor, who garnered national attention in the 1990s for his state's welfare-to-work efforts, has his eye these days on another large entitlement program: Medicaid.
Jointly funded by state and federal governments, the 40-year-old program pays medical bills for low-income, elderly, and disabled people. Thompson is set today to call for overhauling Medicaid by shifting responsibility for long-term care of the burgeoning elderly population to the federal government, while leaving states to focus on acute care for those under 65, particularly children.
"The federal government is the only one large enough to handle this growing problem," said Thompson, who will address the National Governors Association tomorrow in Charleston, S.C.
It's too often an unfortunate side-effect of working in D.C. that all of the problems federal policy creates are viewed as having their solutions in more federal policy. What Medicaid needs is less federal control, and more freedom for states to craft policies appropriate to their individual needs. What long-term care needs is less government intervention and more individual responsibility to cover the costs.
Thompson would do well to read Nobel-prize winning economist Milton Friedman's Capitalism and Freedom, in which he states the following:
[G]overnment power must be dispersed. If government is to exercise power, better in the county than in the state, better in the state than in Washington. If I do not like what my local community does...I can move to another local community, and though few may take this step, the mere possibility acts as a check...If I do not like what Washington imposes, I have few alternatives in this world of jealous nations.
The very difficulty of avoiding the enactments of the federal government is of course the great attraction of centralization to many of its proponents. The great tragedy of the drive to centralization...is that it is mostly led by men of good will who will be the first to rue its consequences.
Government can never duplicate the variety and diversity of individual action...In the process, government would replace progess by stagnation, it would substitute uniform mediocrity for the variety essential for that experimentation which can bring tomorrow's laggards above today's mean.
UPDATE: The verdict is in - Thompson is misguided.
[Stephen A. Moses, "Project Proposal: Controlling Medicaid Long-Term Care Costs," The Flint Hills Center, January 2004.]
It's still too early to say for sure if Tommy Thompson's proposal to overhaul Medicaid suffers from a case of over-centralization, but early indicators suggest that's likely the case:
The former Wisconsin governor, who garnered national attention in the 1990s for his state's welfare-to-work efforts, has his eye these days on another large entitlement program: Medicaid.
Jointly funded by state and federal governments, the 40-year-old program pays medical bills for low-income, elderly, and disabled people. Thompson is set today to call for overhauling Medicaid by shifting responsibility for long-term care of the burgeoning elderly population to the federal government, while leaving states to focus on acute care for those under 65, particularly children.
"The federal government is the only one large enough to handle this growing problem," said Thompson, who will address the National Governors Association tomorrow in Charleston, S.C.
It's too often an unfortunate side-effect of working in D.C. that all of the problems federal policy creates are viewed as having their solutions in more federal policy. What Medicaid needs is less federal control, and more freedom for states to craft policies appropriate to their individual needs. What long-term care needs is less government intervention and more individual responsibility to cover the costs.
Thompson would do well to read Nobel-prize winning economist Milton Friedman's Capitalism and Freedom, in which he states the following:
[G]overnment power must be dispersed. If government is to exercise power, better in the county than in the state, better in the state than in Washington. If I do not like what my local community does...I can move to another local community, and though few may take this step, the mere possibility acts as a check...If I do not like what Washington imposes, I have few alternatives in this world of jealous nations.
The very difficulty of avoiding the enactments of the federal government is of course the great attraction of centralization to many of its proponents. The great tragedy of the drive to centralization...is that it is mostly led by men of good will who will be the first to rue its consequences.
Government can never duplicate the variety and diversity of individual action...In the process, government would replace progess by stagnation, it would substitute uniform mediocrity for the variety essential for that experimentation which can bring tomorrow's laggards above today's mean.
UPDATE: The verdict is in - Thompson is misguided.
[Stephen A. Moses, "Project Proposal: Controlling Medicaid Long-Term Care Costs," The Flint Hills Center, January 2004.]
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