Posted by
Ron Devito on Wednesday, August 12, 2009 6:40:35 AM
Following is Governor Palin's post on FaceBook, delineating how she
reduced a Medicaid backlog by 83% in Alaska over a two-year period:
Contrary
to some assertions, Sarah Palin has a strong record supporting Alaskan
seniors. For example, Governor Palin successfully obtained approval for
a five year extension of a state program that provided monthly cash
payments to low-income seniors (Palin, 2009, ¶1).
On May 23,
2007, using a rarely invoked emergency regulation, Governor Palin
ordered assistance benefits to continue for Alaska’s neediest seniors
after the Alaska legislature failed to fund the SeniorCare Program.
After her action, the legislature responded, and on July 28, 2007,
Governor Palin signed Senate Bill 4 to continue support for low-income
Alaskan seniors by adopting the Senior Benefits Program. “This program
continues important assistance to Alaska seniors,” Governor Palin said.
“I promised that seniors would not go hungry, and we worked with the
Alaska Legislature to address this critical need.” It was estimated
that 10,700 Alaskan seniors would be able to benefit under the program
(Palin, 2009, ¶2).
Also under Governor Palin’s tenure, on
December 19, 2008, the state stepped in and took over the Mary Conrad
Center, an Anchorage nursing home, when the state determined that there
was “'immediate danger to the health, safety or welfare' of its
residents” (Palin, 2009, ¶3)
So, with this clear record of
support and care for Alaska’s seniors by Governor Palin, what is the
current criticism about? According to the United States Department of
Health and Human Services, prior to Governor Palin’s election in
November 2006, in April of 2006, in an effort to control rapidly
increasing costs for home health care providers, known as the PCA
program, Governor Frank Murkowski’s administration implemented a
screening process for Alaska Medicaid eligible persons by using a Level
of Care assessment (LOC). The LOC assessment was designed for persons
who would otherwise require hospitalization or nursing home care and
was intended to help weed out fraud and abuse (Palin, 2009, ¶4).
By
definition, many of these people were ill, elderly or disabled and thus
in need of personal care attendants to assist them. Only registered
nurse assessors were allowed to evaluate consumers to determine if they
qualified for PCA care. The job of assessing consumers was contracted
out, but the State of Alaska DHHS determined that the hired contractor
had too much backlog. Notably, under federal Medicaid strictures, the
State could not get another private business to bid on the contract. So
the State was forced to take over the job in November 2007. However,
the State DHHS was unable to eliminate the backlog using its own staff,
and the backlog then grew. The Federal DHHS temporarily suspended new
admissions to the PCA program pending audit compliance to handle the
backlog of existing cases and come up with a plan to speed the
assessment process. The suspension has been lifted as of August 12
(Palin, 2009, ¶5).
Further, Gov. Palin’s FY 2009 budget clearly
showed her analysis of the issue as of December 2007, and described
both the problem and the solution long before the federal government
got involved. The backlog issue was discussed and a plan proposed for
improvement (Palin, 2009, ¶6).
The graph below shows that under
Gov. Palin (2007 and 2008) the backlog problem was dramatically
reduced, from 30.9% in 2005 to 4.5% in 2008. Looking at these data, one
can conclude that Gov. Palin substantially reduced the outstanding
percentage of Medicaid assessments by 83% (Palin, 2009, ¶7).
Figure 1.
% Not Reviewed
FY 2008 4.5%
FY 2007 4.5%
FY 2006 23.18%
FY 2005 30.9%
What
is the lesson in all of this? Even with good intentions, the government
generally cannot provide better health care services than the private
sector. Beware of complex federal laws purporting to offer government
health care. For those who want nationalized medicine, take heed of
this lesson (Palin, 2009, ¶8).
More information can be found here:
http://www.facebook.com/note.php?note_id=114345578434
Commentary
Let's distill what Governor Palin did to key bullet points, then we can analyze her accomplishment.
The
first item has nothing to do with Medicaid, but does involve protecting
needy seniors. In paragraph two, we see that the Alaska State
Legislature did not fund the state's SeniorCare program -- at all --
and in in May 2007, nearly 11,000 senior citizens were in danger of
losing their benefits, which involved assistance to buy food. Governor
Palin excercised leadership, and signed a bill (SB-4), which
established the Senior Benefits Program, which picked up where
SeniorCare left off.
In the second item, the State took over a
poorly run nursing home in December 2008. This item is an indirect
accomplishment of Governor Palin's.
The third item forms the
essence of the Medicaid backlog remediation. Governor Palin provided
complete background on this. As she explained, the State contracted
Level of Care (LOC) assessments to registered nurses to determine if a
personal care assistant (PCA) was sufficient for a Medicaid-eligible
senior, or if the person required a hospital or nursing home. But the
contractor was backlogged and federal Government regulations prohibited
the state from bidding the job to another contractor. The state took
the job over in November 2007, but the backlog swelled, because the
state had insufficient staff.
Governor Palin's FY 2009 budget
delineated the problem and the solution, which was implemented.
Remember -- these budgets are done two years early -- in 2008, Governor
Palin did the FY 2010 budget. In 2005, the backlog was 30.5% as she
explained. It dropped to 4.5% in 2007 and remained at 4.5% for 2008.
This is the 83% drop in Medicaid backlog she spoke about.
The
drop occurred two years BEFORE the federal government suspended new
admissions to the PCA program, with that suspension being lifted today
-- August 12, 2009.
From the standpoint of Reagan
Conservatism, we see how this matter was handled principally at the
state level. One of the core values of Reagan Conservativism is a
preference for government power residing at the state and municipal
levels, with a small, limited federal government.
The
over-arching value of a small federal government is predicated upon the
position that larger government is not the answer to life's problems
but more often than not causes or exacerbates them.
In
this case, had the state been able to bid the LOC job out to another
contractor or to multiple contractors, the backlog requiring
remediation would have been considerably smaller in the first instance.
We also see what happened when the state took over -- the situation got
worse. Then, Governor Palin arrived at a solution to address it. But
even her solution required two years to fix that mess.
This
outcome clearly supports the thesis that the federal government should
not meddle with health care. Big government is not the answer to the
problem; it is the problem, and we can see clearly the result of a
single illogical regulation -- the one that prohibited the state from
bidding LOC's out to another contractor.
With this kind of a track record, why would we want a federal bureacrat making life and death decisions about our health care?
References
Palin, S.L.H. (2009, August 11). "Palin Reduced Medicaid Backlog 83% In Two Years." FaceBook, Sarah Palin. Retrieved August 11, 2009 from: http://www.facebook.com/sarahpalin?v=app_2347471856&viewas=1574531555