Written by Phil Cerroni
By Alice Canham
“I think we all understand how expensive health care has become,” Texas State Representative Linda Harper-Brown told audience members at the Irving Health Care Summit held Sep. 21 at the Four Seasons Resort in Las Colinas. Sponsored by the Texas Conservative Coalition Research Institute (TCCRI), the gathering was the first of three to be held across the state to solicit debate and discussion about Medicaid and the changes faced under the Patient Protection and Affordable Care Act (commonly referred to as “Obamacare”).
TCCRI will focus on three key goals according to Harper-Brown, who is President of the non-profit coalition.
“I think we have the right idea in Texas, about not expanding Medicaid,” Harper-Brown said. “In the current state budget, Medicaid is the second-largest expenditure, behind education. That is just not sustainable, not only for us, but for other states around the country. If you advocate for this, you are in fact advocating for increasing the national debt.
“Second, we must redouble our efforts to pursue cost containment, such as [creating] a block grant of Medicaid funds, removing the strings attached, so that we could be innovative with our Medicaid program. Wouldn’t it be nice if each individual state could determine on their own how to spend their Medicaid dollars, and determine that based on the needs of each state, versus what the federal government tells you that you have to do?
“Clearly there is a great deal of fraud within Medicaid and the cheaters are skimming substantial resources. We’ve all seen reports about the abuses in billing for dental care in Texas - paying out more than all of the other top ten states combined.
“Lastly, the free market must play a greater role in health care delivery. Private enterprise has developed ideas and systems that increase access to healthcare. Two promising examples are ‘telemedicine’ and the urgent care plans that make healthcare so much more accessible, affordable and available.”
Harper-Brown was followed by Merrill Matthews, Resident Scholar with the Institute for Policy Innovation who spoke of the “explosion” in Medicaid beneficiaries.
“The Affordable Care Act provision of the President’s health care bill is going to expand that by 16 million more people,” Matthews said.
“Right now, 40 percent of the births in America are paid for by Medicaid. In Texas, it’s about 56 percent. Something’s not right about that.”
Figures provided by Matthews indicated that Medicaid spending growth in the past decade has outstripped the growth of the economy, creating a welcoming environment for fraud. “One government official, quoted in a newspaper study a few years back, estimated that 40 percent of the spending on Medicaid in New York City was fraud,” Matthews told the group. “They finally prosecuted one dentist there when he claimed he’d done 991 procedures in one day.”
A panel discussion followed, moderated by John Colyandro, TCCRI Executive Director, and featuring Doug Wilson, Inspector General of the Health and Human Services Commission, Troy Robb of Rescare Residential Services, LeAnn Behrens of Amerigroup Texas, and State Representatives Cindy Burkett and Kelly Hancock. The group picked up on the theme of identifying and controlling fraud.
Doug Wilson, whose role with HHSC focuses on orthodontics, said that his division prosecuted 12 cases of suspected in fraud in 2011, and that number had jumped to 108 so far in 2012.
“We just don’t know how much fraud is going on out there,” Wilson said. “But we know we can do this better.”
Still others found reason for concern in the strictures that would be imposed by the Affordable Care Act (ACA).
“I did some research that really surprised me,” said Hancock. “There are faith-based organizations out there, and just the way that they’re set up, they’ve had physicians volunteering their time and their services to the indigent, in order to provide health care at no cost to individuals who couldn’t afford insurance.
“They tell me that the minute everybody in the United States is forced onto a Medicaid-type program, they will no longer be able to provide those services. The ACA will actually cause these organizations to discontinue programs that are actually working.”
For Hancock and other panel members, though, the most pressing issue was the size of government.
Hancock was met with a chorus of nods when he said, “the larger government gets, from a revenue standpoint, the larger it has to get from a personnel standpoint. So the more dollars we push through the system, the larger the role that government takes on. Several of us would like to reduce that role and put it back in the hands of the consumer.”
For more information about TCCRI and additional Summits to be held in Houston and Austin, visit www.txccri.org .