Stanley Feld M.D.,FACP,MACE
Governor Bobby Jindal of Louisiana is about to unveil an overhauled Medicaid program for his state. It remains to be seen whether he is going to do it correctly and whether the federal government will support him.
He has hinted that he understands the healthcare system's problems. Governor Jindal is a Republican governor. The Republican Party’s mandate is to transfer all entitlement programs to the private sector. The result will not be favorable to patients or physicians. Total control of Medicaid by the healthcare insurance industry would mean less access to care and greater profits for the healthcare insurance industry.
“Louisiana’s efforts to improve health-care outcomes must put more power in the hands of doctors and patients and should also include broad public health measures, such as improving nutrition and boosting physical education requirements in schools, Gov. Bobby Jindal said Wednesday.”
The social contract of medical care should be between the doctor and the patient. It should not be between a third party such as the government or the healthcare insurance industry and the physicians or patients.
The government should be responsible for broad public health measures such developing a culture of good nutrition and physical activity in the schools and public service campaigns to combat obesity and promote healthy living.
"It really is looking at health, not just health care," Jindal said, citing Louisiana's higher rates of diabetes, obesity and asthma as chronic conditions that can be improved through a sharper focus on public health.”
“Without providing specifics, Jindal said he would favor legislation to encourage more physical education in schools and improve nutrition in school vending machines and lunches.”
Governor Jindal’s plan to revise Medicaid is called Louisiana Health First. Early indications are that it will be a sweeping overhaul of the ineffective Medicaid system. Early indications are that it will not support the concept of a social contract between patients and physicians.
“The plan, dubbed Louisiana Health First, would turn over large chunks of the program to privately run managed-care organizations, which would oversee the health care of as many as 380,000 residents, mainly children.”
We have seen that managed care does not work. It is really managed costs. Managed care usually restricts access to care in order to manage costs.
Governor Jindal is right in the public health area but dead wrong with his managed care organization proposal. He will just be providing a money making vehicle for managed care organizations (healthcare insurance industry) while not improving the health of the people of Louisiana.
“Jindal said he hopes to get the changes approved before the Bush administration leaves office Jan. 20, as the change to a new president could delay the state's plans. "We simply don't want to start over from scratch," Jindal said”.
He wants the change before January 20th 2008. He would love to sneak in a plan that would outsource state and federally subsidize Medicaid to managed care organizations. The Republican Party's goal is to abandon entitlement programs and hand them over to the private sector (healthcare insurance industry).
President Bush tried to privatize social security. If he was successful it would have been a disaster given the present financial crisis. The President is in the process of privatizing Medicare with the Medicare Advantage program. The administration is paying a premium to the healthcare insurance industry to accomplish the transfer at the expense of taxpayers and seniors. Massachusetts is privatizing universal care and experiencing large cost overruns.They will all fail.
Who do you think will lose? Patients and physician will lose. The only reform program that will work will be to provide incentives for consumers to be in control of their healthcare dollar along with a reward system for consumers if they responsibly maintain their health.