The gridlock-ness monster: the governors' proposal to save Medicaid from itself is going nowhere fast

Article Abstract:

A proposal by the National Governors' Assn (NGA) to restructure Medicaid enjoyed early acceptance but later was attacked by the American Hospital Assn (AHA), the NAACP and the American Academy of Pediatrics. The NGA's proposal entailed discontinuing Medicaid as an entitlement, reducing federal spending, maintaining health care coverage, and allowing states complete freedom to alter the program. The AHA, and others, oppose the NGA's plan to permit states to reduce their Medicaid matching portion by 20% while continuing to receiver the same amount of federal funding.

Medicaid, Political activity, Economic policy, National Governors' Association, American Hospital Association

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Home health on the high wire: in the search for Medicare savings, politicians sidestep important structural questions

Article Abstract:

Pres Bill Clinton and Congress may consider making Medicare's home health program a system of prospective payments instead of the present cost-based reimbursement approach. The goal would be to control home health expenses, which have risen mainly because of wider access to the system. However, politicians have largely neglected to examine whether home health services actually yield the expected savings and quality improvements over hospital and nursing home care.

Home health care services, Home Health Care, Clinton, Bill, Social policy, Political aspects, United States. Congress, Home care services

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Budget balance

Article Abstract:

The integrated nature of health care in the 1990s blurs the lines amongst clearly delineated segments of the industry, rendering some lobbying efforts injurious to overlapping health care programs. Efforts to balance the federal budget threaten the funding of Medicare, Medicaid and other health programs; health organizations which lobby on behalf of their interests may be compromising budgeting for related programs.

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