SALT LAKE CITY (ABC 4 News) Elective C-sections have come under fire from insurance companies and medical associations. A Utah Senators’ comments about eliminating them for Medicaid recipients created a fire storm. Senator Daniel Liljenquist, R-Bountiful, says while it’s the gained the most attention, it is just one component of much needed Medicaid reform. “We need to make sure that our doctors have a say and we don’t want the legislature to get between the doctor and patient, but the framework with Medicaid right now, it’s just unsustainable.”
Liljenquist just returned from a meeting with the director of Medicaid in Washington D.C. He says the administration is open to reform suggestions. “They too are very interested in getting a handle on growth of costs in Medicaid, and very interested in making sure the system doesn’t collapse in three years when it’s expanded.”
In three years, federally mandated health care reform begins. Utah’s Medicaid system is expected to see a 56-percent increase in the number of people on Medicaid. Liljenquist says Medicaid expenditures are already growing at a rate three times greater than the Utah’s budget. “In order to slow down this runaway train we have got to have everything on the table and look at it.”
Funding for Medicaid is federally mandated, and right now Liljenquist says it is consuming twenty-percent of the State budget. He says it has seen double digit growth for the past fifteen years. He says those numbers are not only due to increases in enrollment but also greater utilization of services. “We are doing more elective procedures, we are doing more prescriptions, which on Medicaid we don’t require co-pays, and it’s very inexpensive so the incentive is to sometimes over-utilize when you are on Medicaid.”
He would like to reform the way doctors are paid, how Medicaid doctors are selected, and have clear standards of care that determines when a procedure is offered. “We can’t have Medicaid patients going to one doctor one day and another doctor another day. Coordinating care is important, and also having clear standards of care of when something is necessary.”
Lincoln Nehring from Utah Health Policy Project agrees Medicaid reform is necessary but says it’s difficult to separate from health care reform in general. He says if Medicaid becomes difficult to use, patients will not utilize it, and will head to the Emergency Room for treatment. He says that will not be cost effective. “Low income people are people too and you can’t expect them to do more than what you would expect everyone else to do.” He also says it’s important that physicians decide what is best for patients, not lawmakers.
