Meridian Star

July 19, 2008

Medicaid and the playground of politics

By Fredie Carmichael / editor





Picture this childhood playground scene: Little Billy sits in the sandbox with his friends. With his legs crossed, scowl on his face, he says: "I'm not playing with them until they play fair. And until then, we're not only not playing, but we're also gonna tell everyone how ugly their momma is."

At the other end of the playground, Little Haley stands on the merry-go-round. With his chest poked out, fingers pointing down, he tells his friends: "Our rules are fair and this is the ONLY way we're going to play. I guess we'll all have to suffer until they finally see how wrong they are."

Meanwhile, all the little kids who want to play kick-ball are left twiddling their thumbs. What began as a time to play, have fun and enjoy an outside activity has become a stalemate between two playground bullies.

This, in a sarcastically over-simplified way, is what's going on between Gov. Haley Barbour and House Speaker Billy McCoy over the state's Medicaid funding. And until it's resolved, those left suffering are the very people — the neediest of our population — who stand to suffer the most.

It's a politician’s most over-used ploy: when in doubt, talk above them. We see it happen all the time. If there's a confusing issue, and Medicaid funding is most certainly that, then political games can be played. The reason: the facts can be distorted and the real truth hard to discern; voters are left wondering, "who do I believe."

Don't let anyone fool you, the issue of Medicaid funding has become an "us" versus "them" or, more accurately, Republicans versus Democrats.

You're either "fer us" or "agin us."

The governor, however, certainly has the advantage in this battle.

First off, the Senate overwhelmingly, and on a bipartisan vote, passed Senate Bill 2013, which is a funding mechanism backed by the Mississippi Hospital Association that will help solve the $90 million funding gap and provide a solution to the program. It’s essentially a revamped version of the way the funding worked years before the federal government disallowed a portion of the way it was set up.

The governor has called lawmakers back to the capitol for an Aug. 4 special session for the House to reconsider the bill, one that's fair and is most certainly a best-case option at this point for the state. Simply put, it just makes sense.

Speaker McCoy likes to talk about the cigarette tax and how it should be used as a funding mechanism for the $90 million hole Medicaid currently finds itself in. He's right — it's a great idea, especially down the road. The problem: it won't happen this year. His own House-mates couldn't even pass a cigarette tax. So does he really think he would have the votes to override a presumable Haley veto? Of course not. He's playing politics.

This is, at its core, nothing more than an attempt to make Haley and the GOP look bad with a presidential race and congressional race on the horizon. They want him to be stuck with making these cuts. Then, when grandma can’t get the healthcare she needs, they’ll point the finger at him.

To be fair, the governor isn't blameless in this. But he was certainly much smarter in his approach to the fight.

The state has yet to make a Disproportionate Share Hospital, or DSH, payment or Upper Payment Limit, or UPL, payment to hospitals for 2007. Locally, for Rush Hospital, that's more than $5 million the healthcare provider is eagerly awaiting from the state, according to hospital officials.

This week, the governor said he hopes to get those hospitals some of that money before the summer ends so hospitals can "get a little relief." Some hospital officials don't think the timing is a coincidence … and it’s much easier to back a plan when you’re hurting for money.

Still, they support SB 2013 because it’s the best option and it makes sense.

Politically, the governor comes out looking much better in this fight. If he's playing politics with this issue, why would he offer to tax the very health care community who put him in office? It's a tough argument for the House leadership to make. But I doubt that will stop them from making it … or scaring you into thinking that your healthcare costs are going to skyrocket due to this bill.

At the end of the day, this shouldn't be about politics, it should be about solving a problem with sound policy, something Senate Bill 2013 accomplishes. Sen. Hob Bryan, D-Amory, is far from a political ally of Haley Barbour’s. And he’s not a conservative Democrat; he’s liberal.

But he also realizes common sense overrides politics.

The political posturing is “not in the best interest of the taxpayer,” Bryan said.

So, if this really were a playground fight between two playground bullies, I sure hope Little Billy would relent this time. Maybe he’s been right in the past. And maybe he’s tired of Little Haley stepping on him in the past. Maybe he thinks Little Haley could be nicer to him and his friends. While those may be valid points, I hope Little Billy would realize this is not the time to fight those battles.

If this battle continues, everyone in the playground will suffer.



Fredie Carmichael is editor of The Meridian Star. E-mail him at fcarmichael@themeridianstar.com.