Calif. Medicaid Among Top 10, but That’s Faint Praise
California’s Medicaid program ranks among the 10 best in the nation, according to a report released today by the Public Citizen Health Research Group, a public interest organization.
Nevertheless, the report--which names Minnesota as having the best program--says all the states have deficiencies in their programs. Thus, California’s high rating “demonstrates the overall mediocrity of state Medicaid programs more than it signals the state’s excellence,” according to the study.
“The promise of equal access and equitable provision of medical care for the poor of this country continues to be denied,” says Dr. George Silver, a public health professor at Yale University who served in the Department of Health, Education and Welfare at the time Medicaid was enacted.
The 257-page report--one of the most extensive compiled on the state-federal program--says the entire program should be revamped from top to bottom.
‘Grossly Inadequate’
“While it has improved access to health care for millions of people, Medicaid has nonetheless proven grossly inadequate for millions of others,” the report says.
Calling Medicaid “a shaky edifice,” the report said it “makes a mockery” of President Lyndon B. Johnson’s statement after signing the program into law in 1965 that “today we expect what yesterday we could not have envisioned--adequate medical care for every citizen.”
Cataloguing huge state-to-state disparities in the way the program is financed and administered, the report says the only solution is for the federal government to assume total financial responsibility and impose nationwide eligibility standards and benefit levels.
Dr. Sidney M. Wolfe, the director of the health research group, told a news conference, “The findings of this report are really a screaming reminder to millions of poor people that, as is the case in the Union of South Africa, health care is not a right.”
‘Leveling’ Has Failed
The report said an attempt to “level the playing field” by having the federal government contribute a larger share of financing to poorer states has failed.
“The federal government does contribute a larger percentage of expenditures in poorer states--for example, an 80% subsidy instead of the 50% a richer state receives--but the actual dollar amount of federal contributions per poor person is lower in poor states than in rich ones,” it said. “This is because under the matching system, states trigger federal contributions only when they themselves spend. Thus, when poor states constrain their own spending, they limit federal contributions, keeping overall spending per poor person low.”
The group, a Ralph Nader organization, arrived at its state rankings by assigning numerical values to 72 separate scoring items in five general categories. The maximum possible score was 350 and Minnesota scored 264. Mississippi came in at 133.
