May 27, 2015

The medical industry that makes money off the Medicaid entitlement spending is spinning the story through blogs and the News and Observer that there is no Medicaid spending problem in North Carolina.

Here are per enrollee cost figures from the Book of the States 2012 by the Council of State Governments. North Carolina is classified in the southern region.

Alabama $5086

Arkansas $5871

Florida $5855

Georgia $4835

Kentucky $7089

Louisiana $6371

Mississippi $5850

Missouri $8398

NC $7275

Oklahoma $6265

SC $6606

Tennessee $5150

Texas $6469

Virginia $7088

WVA $6886

West Virginia, Virginia, Texas, Tennessee, South Carolina, Missouri, Mississippi, Kentucky, Georgia and Florida all use managed care and out of the 15 states, North Carolina is the second biggest spender.

If North Carolina could match Virginia, saving $200/enrollee, Medicaid spending could be reduced by $360 million based on 1,800,000 recipients. If we matched Florida, we would reduce the budget by $2.5 billion.

The point is simple. Most states in our region spend less on Medicaid than we do. Most use managed care as part of their solution.

It’s our contention that managed care companies should compete for the Medicaid contract. CCNC should compete. And whatever medical industry ACOs that want to compete should be free to do so.

Competition will kill the need for insider lobbyists working for CCNC, the medical industry and managed care. Competition in Medicaid, not a monopoly, is a hope for better fiscal control. And competition should start now, not 5 years from now because delay only gives CCNC, their bloggers and lobbyists time to strangle Medicaid reform before it gets started.