“Fifty percent of all births are covered by Medicaid, one of three children in Illinois is on Medicaid and one of five Illinois residents is on Medicaid. More than 2.5 million Illinois residents are on Medicaid and the program’s exploding costs are bankrupting Illinois.” Editorial, The News-Gazette, July 19, 2011.
Assuming that the editorial writer got his facts straight (never a safe assumption) those figures paint an ominous picture of the State of Illinois. Half of all of the children in Illinois are born into families living at or near the poverty level. A third of all of the children in Illinois live in families at or near the poverty level. A fifth of all of the people of Illinois are living at or near the poverty level. But that analysis is flawed. It considers only those Illinois residents who have applied for and found eligible for Medicaid coverage. It does not reflect those who have not applied for the program whether because they did not need or seek healthcare or who out of either pride or ignorance chose not to apply for coverage.
The editorial writer’s thesis seems to be that it is the indigent patient who is responsible for what he calls “the program’s exploding costs” and the solution to the rising cost is to make it more difficult for folks to establish their eligibility for the program. To him cutting costs means cutting the number of indigent patients who are served by the system – rationing access to health care according to the wealth of the patient not according to the person’s need.
We are not going to be able to control the cost of the Medicaid program until we develop the political will to impose controls on what medical care providers can charge for their services. That is where Medicare costs are exploding not in the number of indigent patients who are served by the program.