There’s a somewhat misleading story in Sunday’s Star Tribune newspaper. The story claims that Minnesota’s Medicaid costs are “soaring”. Therefore the only solution to the “runaway Medicaid spending” is to cut aid to elderly Medicaid beneficiaries. This is nonsense and the story poorly represents the issue.
First of all, I am surprised that the paper allowed the loaded “soaring” and “runaway spending” language to pass. These are value-laden terms that represent political opinions, not facts. Look a little closer.
The reporter tells us that “Minnesota is implementing stricter rules” — in other words cutting benefits — to “constrain runaway Medicaid spending.” Two paragraphs later, we learn that the state claims the changes are necessary because at some future time — not disclosed — increasing numbers of baby boomers will overwhelm the system.
In other words, the problem isn’t runaway costs, it is too many people. Or, more specifically, too many old poor people. But to say that we have too many old poor people therefore we need to cut benefits doesn’t sound quite as responsible as saying we have soaring costs and runaway spending, does it?
In this context even good news looks bad. The paper published a chart showing nationally the amount spent by states on Medicated benefits. Minnesota ranks near the top at seventh. This might be something that would bring pride to the tax payers of Minnesota. In this story it adds to the sense of excess.
In the end this is a political question. Do we provide these benefits or not? And how will we pay for them? Clearly policy makers and politicians should have known that some day baby boomers would age and need assistance. At the very least this is an example of poor underwriting.
But the truth is more like an example of poor policy making. In an era when government is seen as an inherently wasteful system that needs to be cut, it is hard to find people standing behind commitments to the poor and neediest. That old lady down the street living alone needing help getting dressed and bathed is a taker, not a maker.
No, we don’t have runaway spending and soaring costs, but we do have dwindling interest in funding public programs. That’s the problem. We cut taxes when we cannot afford to cut taxes. That pushes us into this false conundrum that is sold as out-of-control spending. Whether we choose to fund programs or not is a political choice. Politics — not spending or even economics — is at the root of so-called “runaway” spending. We are under funding our programs and commitments. That’s a political problem.
In this story this political problem couldn’t be more clear. The state is indeed looking to the future and it is making a preemptive choice to cut services before raising funding. (Raising more money today — especially to help the poor — is a non-starter.)
This is different from the more common strategy of cutting funding first in order to under fund programs and thereby force cuts in the future. So perhaps Minnesota state officials are at least being honest and pragmatic. We’re making a choice and telling the old poor people it’s tough luck on them rather than hiding behind some created financial dilemma. In today’s short-sighted political environment, can we expect anything better?
The truth stinks.
A Little Tour in Yellow 