April 12, 2005

The New York Times > Washington > U.S. Says Medicaid Money Was Obtained Improperly

The debate crescendo rises. Vermont is not on the list of states apparently doing the hanky-panky with Medicaid. We have a health care system out of control. The costs of being well, not wanting to die, research and administration are only brought under control by rationing.

No one uses the term. No one wants to think of the consequences, but in the end, that's the only answer. First order of business is to drive out inefficiencies. But one person's inefficiency is another's bread and butter. Now, let's debate what is rationed and how it will happen. Do we ration care or money? Who does the rationing and on what basis? Until we are willing to engage that debate, we will make little progress.

Whenever costs need to be controlled, industry has used the terms, re-engineering, right-sizing, out-sourcing, smart-sizing, etc. In the end, they all mean that costs have been reduced and that that has meant less of something, usually the number of American workers employed for the tasks.

Not a pretty picture, but we need drastic action...soon.

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