Tuesday’s Wall Street Journal had an interesting little blurb in one of it’s two editorials that I’m going to come back to in an upcoming post, but I figured the blurb was worth posting now.
Medicaid isn’t in trouble because it is badly run, though of course it is. The problem is that it has become so vast and is meant to fill so many political demands that no one can truly control it. Given the Obama Administration’s rigidity, this is not the best reform moment, but unlike his predecessors, Mr. Cuomo seems to recognize that these liabilities can’t be repaired at the margins. The real test will be if he starts to do the politically difficult work of scaling Medicaid down.
My readers will note that their reference to “repaired at the margins” sounds a lot like the “tinkering around the edges” phrase I often use. It all means the same thing. Again, I’ll come back to this editorial in a day or so, but I felt this was worth posting now. The final point of focus, is that Medicaid has simply gotten out of control. As the editorial suggests, this is no time to make marginal changes, to “tinker around the edges”, it’s time for an overhaul. More later.