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Ellen Belcher is the Dayton Daily News opinion pages editor. She writes about state government, education, the environment, higher education and all things Dayton.
Martin Gottlieb is an editorial writer and columnist for the Dayton Daily News opinion pages. He focuses on the political process itself and does such national issues as war, the economy, taxes and Social Security, as well as a hodge-podge of local and state issues.
Scott Elliott is an editorial writer and columnist for the Dayton Daily News opinion pages. He writes about education, city and suburban issues, politics, business, workforce and consumer issues.Home > Blogs > A Matter of Opinion > Archives > 2010 > July > 23
Friday, July 23, 2010
Editorial: Medicaid just one place Ohio will cut
So you might have heard that the health care problem got fixed with the passage of President Barack Obama’s health care plan.
Not so much for states.
At this week’s hearing on how Ohio is going to navigate a budget deficit that could hit $8 billion (representing 15 percent of current state spending), Medicaid was the focus.
The numbers are breathtaking:
— Medicaid costs are approaching 60 percent of the state’s budget.
— Medicaid spending has increased 30 percent in just the last three years. (It was more than a decade ago that former Gov. George Voinovich called it the Pac-Man of the budget. Not much has changed.)
— One in seven Ohioans, and one in three Ohio children, are covered by Medicaid. That number will go up as income eligibility rules are loosened under the Obama plan.
— A $3 cut in Medicaid spending only saves $1 because of the way the state gets reimbursed by the feds.
There are lots of misconceptions about Medicaid. For starters, it’s not a Cadillac plan in every sense of the word. As grateful as many people are to have the coverage, it has drawbacks. Many doctors, for instance, limit how many Medicaid patients they’ll accept, so it’s not always easy to get the care you need.
Though you might think it’s poor families who are running up the bills, one of the biggest drivers is nursing home costs. Many elderly Medicaid patients were not poor until they blew threw their savings paying for their or their spouses’ nursing home bills.
One particularly difficult challenge is that 5 percent of Medicaid cases account for 50 percent of the spending. Cutting costs for incredibly sick, dying or disabled people will never be easy. That limits where the state can go in the program to save money.
All of these issues and more came up at the Budget Planning & Management Commission meeting this week.
So far, the only helpful thing that’s come out of that effort is the media coverage that has exposed how unwilling both Republicans and Democrats are to concede and deal with the depth of the financial crisis. Both sides are more engaged in making the other look bad as the election approaches than with getting down to the nitty-gritty.
Nonetheless, the group is going to keep meeting, even as there’s not much hope that the level of discussion will pick up.
Some groups — the state’s certified public accountants, for instance, and the Center for Community Solutions out of Cleveland — are taking the opportunity to be heard about how they see the financial challenges and choices. Other informed groups should invite themselves to the table; if nothing else, they can help fuel a public education campaign about what’s ahead.
Ohio’s budget problems are not as dire as some other states, but they are monumental. Schools, local governments and all the places — from libraries to hospitals — that depend on state funding have a stake in how the budget gets balanced.
When you’re listening to the candidates for governor and the legislature this fall, don’t settle for platitudes. The people you pick will be making big decisions that affect your wallet, family and the place you live.
This is no ordinary time, no ordinary election.
Permalink | Comments (17) | Post your comment | Categories: Editorials, Ellen Belcher, Health Care, Ohio government, Ohio politics, Social Services
Editorial: Strickland wrong but within rights on tobacco
A bipartisan effort in Columbus to basically defund anti-smoking programs has resulted in a backlash. At odds now, instead of two parties, are the leaders of two successive legislatures.
The issue is playing out at the Ohio Supreme Court, where the question is whether one legislature can bind the next.
At stake is more than the future of anti-smoking programs.
The story starts back when Ohio won $10 billion from the tobacco industry as a result of lawsuits in which a lot of other states won money, too. The money was supposed to deal with the harm to public health and public finances done by tobacco.
Nearly all that money has long since been applied to matters having nothing to do with smoking. But the last quarter-billion or so was set aside for anti-smoking efforts. The idea was not to actually spend that money, but to endow a fund and spend the interest on helping people to quit and encouraging everyone else never to start.
Then, to make a long story short, the economy took a turn for the worse, and Gov. Ted Strickland and the legislature decided they needed the tobacco money for the general fund. They undid the endowment arrangement.
Some anti-smoking people took them to court, saying the money can’t be taken back, because the governor and legislature gave up control over it.
Lawyers for the American Legacy Foundation say that if the legislature can take back this money, it can take back money from state retirement accounts, a potential horror story. That’s in dispute. The retirement funds have not joined in the lawsuit, though many other outsiders have.
Former Attorney General Betty Montgomery and former Senate President Richard Finan, both Republicans, are on the side of the anti-smoking people. They say they meant to make the tobacco endowment inaccessible to future legislatures. On their side in the court case are various health-related organizations.
But current Senate President Bill Harris, a Republican, and House Speaker Armond Budish, a Democrat, say that their predecessors did not make the money off-limits, and that they could not, at least acting alone. That view is shared by a national organization of state legislatures and, also, by various health groups.
(Health groups are on both sides because the money not going to anti-smoking efforts has now been slated for other health programs, though at first it was supposed to go to Gov. Ted Strickland’s economic stimulus package.)
The question is whether the state had a legal right to reclaim the money.
It did. As an Ohio appellate court ruled unanimously, if the earlier policymakers had wanted to seal off the tobacco money, they needed to pass a constitutional amendment, as other states have. Merely declaring in law that only the trustees of the endowment may spend the money is not enough. A law can be rescinded by another law.
That appellate decision overturned a county judge, who had held that the state had broken contract law by changing its position. But what’s at hand is not really a contract dispute. It’s a constitutional issue.
Legislatures need to understand the limits of their power. If they can easily seal off money forever, they undermine the ability of future legislatures to deal with changing circumstances.
The state certainly should have sealed off some portion of the $10 billion. Tobacco can reasonably be considered the nation’s biggest public health threat, in the absence of some other emergency of the moment. The costs in lives, productivity and dollars are monumental.
But the state simply didn’t do what it should have. It can’t do it retroactively.
Permalink | Comments (6) | Post your comment | Categories: Editorials, Martin Gottlieb, Ohio government, Social Services
Martin Gottlieb: Boehner mellowing?
Politics being a little bit different, John Boehner is not worried about jinxing his chances of being speaker of the House by talking about it. He’s talking about it all over the place. He’s talking about who he is and what he wants to do.
This is all occasioned by certain facts. He’s the current leader of the Republicans in the U.S. House. And the Republicans are widely conceded a shot at winning control of that body in November, which would make him speaker, absent a challenge from within.
Some of what he says is worth hearing.
He bemoans, for example, much about Congress. “This is supposed to be the greatest deliberative body in the history of the world,” he said, confusing the House with the Senate, and overstating the claim for the Senate. (The word “history” is usually not there.)
“But there’s very little deliberation. And I really think that members are being short-changed. I came out of the Ohio legislature, a place where it was a legislature and you were taught and you learned how to become a legislator. And I think that we need legislators in the U.S. Capitol.”
Of course, he’s talking about the Ohio legislature before term limits. Speaking of which, he told a local audience the other day that he’s against term limits, because “all the power gets shifted to the bureaucrats and the lobbyists.”
This is true. Knowledge is power. Term limits make legislators the least knowledgeable people in the power grid.
But all this kind of talk fills certain conservatives with the dread that their leader has gone native.
He’s been in Washington 20 years, a period which began with him insisting that he is “not a politician.” Now he’s presenting himself as the consummate Washington professional, at a time when, as George Will recently put it, being an incumbent is widely seen as a character flaw.
Though he definitely knows some contemporary history by now, pre-Boehner history is apparently not his strong suit. He said recently:
“There’s a political rebellion brewing, and I don’t think we’ve seen anything like it since 1776.”
This was reminiscent of President Ronald Reagan campaigning in 1986 for a piece of bipartisan legislation known as tax reform. It lowered tax rates and paid for that by eliminating some tax deductions; it did not cut taxes.
Though the bill is not even the one Reagan is remembered for most, he went around the country calling it the “Second American Revolution.”
Bigger, say, than emancipation or women’s suffrage? Or the New Deal, which reinvented the role of government in our lives? Or the coming of the common man to the presidency, via Andrew Jackson?
Sometimes you get the impression that these politicians think there was the American Revolution, and now there’s them, and in between was a lot of, what, boredom?
Boehner may be no worse than the rest of them on this score. But here’s a suggestion to a guy who likes his leisure time: turn off Fox and turn on the History Channel.
As for the issues of this particular day, when Boehner turns to policy, he successfully reassures many conservatives that he is not going soft.
True, a certain restraint occasionally arises. For example, in response to a citizen’s question about health care repeal if he becomes speaker, he said, “I guarantee there will be a bill on the floor that will repeal the health care bill and replace it with common-sense reforms.”
Not much a guarantee: “a bill on the floor.”
When pushed, though, he hands out the political red meat.
A questioner in an audience: “No matter what you guys pass, Obama will veto it, right?”
As reported by Cox Media Group reporter Josh Sweigart, Boehner responded that that isn’t necessarily true, that there is bipartisan support to repeal cuts to Medicare.
Anyway, he said, “They’re not going to get one dime from us to hire these new federal employees to run this.”
In truth, if Obama signs something that undermines his most historic presidential accomplishment, he will amaze a lot of people, starting with Michelle.
Nevertheless, Boehner paints himself as unusually frank.
“I am not Barack Obama and I am not Nancy Pelosi,” he said. “I say what I mean, and I mean what I say. And those of you who have dealt with me over the years know that that’s a fact and it will remain a fact.”
Permalink | Comments (6) | Post your comment | Categories: Columns, Elections, Locals in national affairs, Martin Gottlieb, Miami Valley Politics, National Politics
