June 16, 2005, latimes.com :
50 Governors Unite Against Federal Cuts to Medicaid
· Their plan would add some restrictions and give states more say.
The bipartisan effort goes against Bush's plan for reducing spending.
By Ricardo Alonso-Zaldivar, Times Staff Writer
WASHINGTON - Governors stepped up their campaign against the Bush
administration's proposed cuts in Medicaid on Wednesday by presenting
Congress with their own ambitious plan to restructure the safety-net health
program that serves about 53 million Americans.
The new proposal, backed by all 50 governors, would give states more
latitude in reshaping benefits and trimming costs. It would cut into drug
company profits, but also would make it harder for middle-class families to
shift assets in order to get the government to pick up nursing home bills
for elderly relatives. It could force the poor to pay more for medications,
but it would also help uninsured low-income workers get coverage.
"The Medicaid program is not sustainable in the long haul," Virginia
Gov. Mark R. Warner, a Democrat, told reporters before he and Arkansas
Gov.Mike Huckabee, a Republican, formally presented the plan to the
Senate and House committees that oversee the program.
The proposal has "the support of the governors of America, no matter
what state they live in or what party they're from," Huckabee added.
"We may be the only bipartisan game in town," Warner said.
The show of unity puts President Bush in an awkward political
position. Cuts in Medicaid are an integral part of his plan to lower the
deficit by cutting spending while making his first-term tax cuts permanent.
Congress has already reduced Bush's initial proposal for Medicaid cuts
from $60 billion over five years to $10 billion, and Warner urged Wednesday
that Congress make immediate cuts in other programs. Lawmakers should
focus on modernizing Medicaid to make it more cost-efficient, potentially
saving more in the long run, he said.
The governors' plan pointedly included no savings estimates. Even
lawmakers who were sympathetic warned there would be cuts when
Congress attempted to write a deficit reduction bill this fall. But several
senators agreed with Warner that at least part of the $10 billion could come
from other programs.
"It is a challenge to the administration," said Marilyn Moon, a health
economist at the nonpartisan American Institutes for Research. "The
governors have been fairly united in rejecting the idea of starting out with
a $10-billion goal. They are essentially saying, 'If you want us to
participate in any of this discussion, you can't dictate what the budgetary
outcome will be.' "
Medicaid is a $329-billion-a-year program, jointly funded by federal
and state governments. It serves a broader range of people than any other
public or private health program. Beneficiaries include Alzheimer's patients
in nursing homes, the healthy children of low-income working parents,
families on welfare and severely disabled accident victims.
About 6.8 million Californians are served by Medi-Cal, the state's
version of the program.
Expansions in coverage and a soft economy have turned Medicaid into
the fastest-growing component of state budgets.
"We're getting hit with a triple whammy," said Warner. "We've seen the
federal government try to shift costs to the states. We've seen employers
who for economic reasons don't provide health insurance to their workers
encourage them to go on Medicaid. And we've seen Americans trying to
get rid of Mom and Dad's assets before they go on long-term care. We can't
deal with all of them."
At the same time, a maze of federal and state laws and regulations -
some dating back four decades - makes it very difficult to change the
program.
Medicaid "is a 45 rpm program in an MP3 world," Huckabee said. "It's
time to take a fresh look - not so we can undo it, but so we can better do
it."
The governors' proposal has several major elements.
An arcane formula used to determine what Medicaid pays for medications
would be changed to leverage the program's purchasing power and force
deeper discounts from drug makers. The Bush administration has mainly
been pressing for discounts from pharmacists. That change alone could
save "multiple billions," said Warner.
Eligibility rules for nursing home coverage would be tightened to
prevent families from shifting the assets of elderly relatives so they can
qualify for Medicaid coverage. At the same time, the governors said Congress
should promote the purchase of long-term-care insurance, encourage the use
of home equity to pay for long-term care, and set threshold amounts that
seniors can pass on to their heirs while still qualifying for Medicaid.
States would be allowed to charge higher co-payments for Medicaid
prescriptions and other medical services, a proposal that brought sharp
rebukes from several Democratic lawmakers.
"You are ready to ask for co-payments from poor children, but you are
not willing to come here and say the federal government should stand with
the states to meet its obligations," Rep. Henry A. Waxman (D-Los Angeles)
told Warner.
Other parts of the proposal called for giving states more flexibility
to design benefits, making it easier for them to obtain exceptions to
federal rules, requiring federal officials to defend such exceptions in
court if states are sued, and increasing Washington's contribution to
Medicaid programs in U.S. territories, such as Puerto Rico.
The governors also said Medicaid reforms should be used as a
springboard to reduce the number of uninsured people. They urged a
broader menu of tax credits for health insurance than Bush has proposed.
The administration's point man on Medicaid, Health and Human Services
Secretary Mike Leavitt, had no immediate reaction to the governors'
proposal. Leavitt is overseeing a commission that will recommend savings to
Congress in the fall, but Democrats in Congress have denounced the panel as
partisan.
Families USA, a leading liberal advocacy group, called the governors'
plan "a mixed bag." While denouncing increases in co-payments as "very
destructive," it applauded the recommendations for savings on drug costs.
The Senate Finance and House Energy and Commerce committees,
which oversee Medicaid, are expected to develop savings estimates for some
of the governors' proposals. Discussion among committee members, the
governors and the administration will continue through the summer.
"I think we can come up with policies that improve Medicaid's fiscal
health without jeopardizing coverage and, in fact, we must," said Sen.
Charles E. Grassley (R-Iowa), chairman of the Finance Committee.
The House is likely to press for bigger cuts. The chairman of the
Energy and Commerce Committee, Rep. Joe Barton (R-Texas), said he
was committed to preserving the healthcare safety net, but he also warned:
"Without reform, Medicaid eventually will bankrupt every state in the
nation. The only alternative is the collapse of the Medicaid program."
***
From: bob zoell <[EMAIL PROTECTED]>
Date: Sun, 19 Jun 2005 07:37:08 -0700
To: gary panter <[EMAIL PROTECTED]>
Subject: Fwd: "W" helping us understanding the new plan
PRESIDENT "W" speaks: a verbatim response:
WOMAN IN AUDIENCE: I don't really understand. How is it the new plan
going to fix the problem?
PRESIDENT BUSH: "Because the -- all which is on the table begins to
address the big cost drivers. For example, how benefits are calculated, for
example, is on the table. Whether or not benefits rise based upon wage
increases or price increases. There's a series of parts of the formula that
are being considered. And when you couple that, those different cost
drivers, affecting those -- changing those with personal accounts, the idea
is to get what has been promised more likely to be -- or closer delivered to
that has been promised. Does that make any sense to you? It's kind of
muddled.
Look, there's a series of things that cause the -- like, for example,
benefits are calculated based upon the increase of wages, as opposed to
the increase of prices. Some have suggested that we calculate -- the
benefits will rise based upon inflation, supposed to wage increases.
There is a reform that would help solve the red if that were put into
effect. In other words, how fast benefits grow, how fast the promised
benefits grow, if those -- if that growth is affected, it will help on the
red."
Whew - so glad that's cleared up!
Forward this to others so they can understand as well...
www.bobzoell.com
***
US lied to Britain over use of napalm in Iraq war
By Colin Brown
Deputy Political Editor
"The Independent" - - 06/17/05
American officials lied to British ministers over the use of
"internationally reviled" napalm-type firebombs in Iraq.
Yesterday's disclosure led to calls by MPs for a full statement to the
Commons and opened ministers to allegations that they held back the facts
until after the general election.
Despite persistent rumours of injuries among Iraqis consistent with the use
of incendiary weapons such as napalm, Adam Ingram, the Defence minister,
assured Labour MPs in January that US forces had not used a new generation
of incendiary weapons, codenamed MK77, in Iraq.
But Mr Ingram admitted to the Labour MP Harry Cohen in a private letter
obtained by The Independent that he had inadvertently misled Parliament
because he had been misinformed by the US. "The US confirmed to my officials
that they had not used MK77s in Iraq at any time and this was the basis of
my response to you," he told Mr Cohen. "I regret to say that I have since
discovered that this is not the case and must now correct the position."
Mr Ingram said 30 MK77 firebombs were used by the 1st Marine Expeditionary
Force in the invasion of Iraq between 31 March and 2 April 2003. They were
used against military targets "away from civilian targets", he said. This
avoids breaching the 1980 Convention on Certain Conventional Weapons (CCW),
which permits their use only against military targets.
Britain, which has no stockpiles of the weapons, ratified the convention,
but the US did not.
The confirmation that US officials misled British ministers led to new
questions last night about the value of the latest assurances by the US. Mr
Cohen said there were rumours that the firebombs were used in the US assault
on the insurgent stronghold in Fallujah last year, claims denied by the US.
He is tabling more questions seeking assurances that the weapons were not
used against civilians.
Mr Ingram did not explain why the US officials had misled him, but the US
and British governments were accused of a cover-up. The Iraq Analysis Group,
which campaigned against the war, said the US authorities only admitted the
use of the weapons after the evidence from reporters had become irrefutable.
Mike Lewis, a spokesman for the group, said: "The US has used
internationally reviled weapons that the UK refuses to use, and has then
apparently lied to UK officials, showing how little weight the UK carries in
influencing American policy."
He added: "Evidence that Mr Ingram had given false information to Parliament
was publicly available months ago. He has waited until after the election to
admit to it - a clear sign of the Government's embarrassment that they are
doing nothing to restrain their own coalition partner in Iraq."
The US State Department website admitted in the run-up to the election that
US forces had used MK77s in Iraq. Protests were made by MPs, but it was only
this week that Mr Ingram confirmed the reports were true.
Mike Moore, the Liberal Democrat defence spokes-man, said: "It is very
serious that this type of weapon was used in Iraq, but this shows the US has
not been completely open with the UK. We are supposed to have a special
relationship.
"It has also taken two months for the minister to clear this up. This is
welcome candour, but it will raise fresh questions about how open the
Government wished to be... before the election."
The MK77 bombs, an evolution of the napalm used in Vietnam and Korea, carry
kerosene-based jet fuel and polystyrene so that, like napalm, the gel sticks
to structures and to its victims. The bombs lack stabilising fins, making
them far from precise.
©2005 Independent News & Media (UK) Ltd.
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