Monday, April 7, 2008

Slacker Mandate Advances in Kentucky 

By Marc Kilmer

Categories:  Individual Mandates, Kentucky

The Kentucky General Assembly has approved legislation that will add the state to the growing list of states that require insurance companies to cover adult "children" on parents' insurance. Under the legislation, if the parents want to pay extra, insurance companies will be forced to cover "kids" up to 25 years old. The bill awaits the Governor's signature.

Adding mandates on health care companies only makes it more expensive for these companies to offer policies. I guess Kentucky politicians are not aware of the problems of only considering the seen and ignoring the unseen.

• posted by Marc Kilmer
• 2:49 pm
• 1 comment

Thursday, March 6, 2008

Certificate of Need Reform in Kentucky 

By John LaPlante

Categories:  Certificates of Need (CON), Kentucky

The Bluegrass Institute for Public Policy Solutions notes a promising development in Kentucky: legislation to roll back the commonwealth's certificate of need law.

David Adams says that the rollback is only a "narrow" one, but adds that even a small reform is good. "If," he says, "we can see the wisdom in allowing the market to dictate the supply of medical services and discard -- if only in very limited cases -- the dumb idea that restricting growth of services keeps prices low, we may be on the road to repealing the entire nonsensical Certificate of Need program.

• posted by John LaPlante
• 9:14 am
• 0 comment

Friday, January 4, 2008

Expansion of Kentucky Medicaid Stalled 

Cost overruns, debates over funding

By John LaPlante

Categories:  Kentucky, Medicaid

Sometimes a broken government program is a blessing after all.

Gov. Steve Beshear came into office last year planning to extend the state's involvement in health care. It's already substantial. "About 30 percent of Kentuckians rely on government programs for health insurance, and 13 percent are uninsured," says the Lexington Herald-Leader.

If my math is correct, Gov. Beshear's ultimate goal would be to have 43 percent of Kentuckians dependent on the state government.

The state Medicaid program is already spending beyond the projections of the last governor. In this case, government failure may be a good thing: "Until the Medicaid mess is untangled, it's hard to see how people can be added to the program, lawmakers said."

One can hope that some more work by auditor Crit Luallen will find even more cost overruns. Perhaps that will delay a government takeover even longer.

Unfortunately, the state's two largest chambers of commerce are happy with an expansion, as long as a cigarette tax is used to pay for it. Gov. Beshear resists that move.

The commonwealth's legislature looks to make the market for insurance even worse. One bill would slap a slacker mandate on insurance companies by raising the age of a "dependent" to 26. Another bill would add yet another mandated benefit.

Meanwhile, the Bluegrass Institute for Public Policy Solutions notes that the Herald-Leader mentions not a single option for making insurance more affordable in the private market. 

• posted by John LaPlante
• 10:51 am
• 0 comment

Friday, December 28, 2007

Kentucky Children Take a Gamble on Casino Proposal 

By John LaPlante

Categories:  Kentucky, Medicaid

Jim Waters, of the Bluegrass Institute for Public Policy Solutions, observes that Kentucky's Gov. Steve Beshear is taking a page from those in Congress who would expand government health care programs.

Since the Commonwealth of Kentucky must (unlike the U.S. government) balance its budget, Gov. Beshear wants to create a new revenue stream to pay for his program.

Gov. Steve Beshear apparently favors expanding government spending to provide health insurance to Kentucky’s 81,000 uninsured children. He also forecasts a tight budget. Beshear’s plan to pull this monetary rabbit from a hat involves casinos magically appearing in your backyard and government’s grimy hands making cash disappear from your wallet.

Spin that roulette wheel. It's for the children.

• posted by John LaPlante
• 9:41 am
• 0 comment

Monday, December 24, 2007

Something to Chew On: Dental Care in Kentucky 

Dedicated Dentist Does What A Government Bureaucracy Cannot

By John R. Graham

Categories:  Kentucky, Medicaid, SCHIP

The New York Times ran an eye-opening feature on dental care in Kentucky, the state with the worst incidence of toothlessness in the nation. Smoking, chewing tobacco, and even methamphetamine use are high in Kentucky, and these lead to loss of teeth. This causes a downward spiral of quality of life: “Try finding work when you’re in your 30s or 40s and you’re missing front teeth”. Also, if you can't chew, your diet is limited and you can end up suffering malnutrition.

This being the New York Times, of course, the reporter points an accusatory finger at Medicare, which does not pay for dental care. Well, Medicare's not going to address the dental care of working-age people, because it's for seniors. What about Medicaid, which is supposed to be the safety net for low-income citizens? Forget about it!

Even after the state raised fees for children's dental care by about 30 percent, fewer than one quarter of the state's dentists take Medicaid patients, so low are the rates. Furthermore, under Medicaid, the only choice a person with a severe infection has is to have the tooth pulled, even if she’s 25 years old and the tooth is right in the middle of her face. It does not pay for root canals or dentures, though it does help pay for a liquid diet for those without teeth.

On the other hand, a dedicated dentist, Dr. Edwin E. Smith, has invested $150,000 of his own money in a mobile dental clinic that he takes to Kentucky's poorest areas, giving free dental care to those who would never otherwise see a dentist or dental hygienist.

A colleague and I recently wrote about how the massive growth of the American welfare state had reduced our ability to support our distressed citizens voluntarily. Those who think that relentlessly throwing more money at government programs like Medicaid or SCHIP will improve the lives of our most disadvantaged citizens ignore and disrespect the civic commitment of health professionals like Dr. Smith.

Merry Christmas!

• posted by John R. Graham
• 7:35 pm
• 1 comment