Transparently, responsibly improving health care

Dear Editor:

Louisiana’s physicians and other health care providers perform miracles every day for the citizens who use our state-administered and federally funded Medicaid system, a great comfort to the families of our most vulnerable citizens, and for all of us who rely on a healthy populace to keep our economy moving.

However, if not for the good work of most physicians and providers, our Medicaid program would be considered a failure.

To illustrate the point: Only 40 percent of the women in our Medicaid program received breast cancer screenings last year, putting our performance in the lowest 10th percentile in the nation. Only 35 percent of our adolescents in Medicaid received well-child checkups, putting our performance in the lowest 25th percentile.

It’s no wonder that our death rates from breast cancer and our death rates among children are among the highest in the nation.

One patient in Louisiana’s Medicaid program visited emergency rooms and outpatient centers 30 times and received more than 60 unnecessary CAT scans, exposing him to levels of radiation exceeding 18,000 X-rays. Another patient – a nine-year-old boy – received 13 powerful mental health drugs – many of them harmful when taken with each other – when the boy clinically only needed two medications.

This poor performance is not cheap, either. In fact, this year, Louisiana Medicaid will consume nearly $7 billion – $1.6 billion more than two years ago and a 28 percent increase.

In 2004, Medicaid consumed just 8 percent of our discretionary state fund, but by 2011, it is projected to devour more than 21 percent of our discretionary state fund – eclipsing important other priorities like education, law enforcement, roads and other critical state functions.

On top of all that, in the last month alone, the state’s Department of Health and Hospitals has found that more than $13 million was stolen from you by people who defrauded Medicaid.

Believe it or not, this is likely only a very small part of the total fraud in the system. Attorneys general across the nation estimate that systemic fraud saps as much as 10 percent of total Medicaid spending.

There is no way that we and other state leaders can ask you for hundreds of millions of dollars more of your hard-earned money next year so the system can continue to function this way.

That’s why we are proposing to change the Medicaid system, and Nov. 14, we announced a proposal designed to make it work better for the people it serves while also insisting on accountability in spending and results.

Our proposal will transform Medicaid into an integrated health system for the poor that provides consumers with choice and a medical home, takes an aggressive stand against fraud and abuse, manages chronic disease and decreases emergency room visits, provides incentives for improved health behaviors, and expands the number of people who have health insurance from those languishing on the rolls of the uninsured.

Defending the status quo is not an option. While there are some who may believe Medicaid is just fine the way it is, most people would see our results and ask why we would keep spending hundreds of millions of dollars more each year for a system that consistently rates most poorly when compared to virtually every other state. We cannot afford to make excuses for having among the highest death rates, highest avoidable hospitalization rates, highest cost and poorest access.

Louisiana deserves a more accountable system where those paying for it have the confidence we are spending their money effectively, while citizens who rely on Medicaid can be confident they will be able to access needed care.

Gov. Bobby Jindal and Alan Levine,

secretary of the Department of Health and Hospitals