Utah's economy also took a hit. By cutting $6.6 million in state funds, Utah turned away $17 million in federal funds. This $17 million would have supported nearly 700 Utah jobs, which would have in turn generated $35 million in economic activity.
We all understand that in tight times, budget cuts are necessary. But the main problem with the Medicaid cuts was their somewhat arbitrary nature. The optional services seem expendable from the comfortable perch of the middle class, but for the persons who rely on them for basic mobility or to re-enter the workforce, they are medically necessary.
If the Legislature is determined to squeeze a few extra dollars out of Utah's already lean Medicaid program, the place to look is our state's pharmaceutical purchasing strategies or managed-care contracting arrangements. In the time it might have taken to implement such strategies the Legislature could have bonded for road projects without losing its AAA credit rating.
The real irony is that the whole tragedy could be avoided if policymakers would consider one of the critical first steps in reform recommended by most stakeholder groups: a health benefits commission.
You might think that the services covered by your health-care plan are covered because they are the most effective. You'd be wrong. Instead, there is a good deal of money wasted on services that provide minimal benefit, or which are targeted to the wrong populations. No wonder that 40 percent of our health-care spending has no value!
But this is an eminently fixable problem, and there is strong consensus across stakeholder groups (hospitals, physicians, advocates and businesses) to seek better alignment between the "benefits" offered by health plans and the value they are supposed to provide.
Not only would the commission help to identify the right services to cover, but it could determine the right way to distribute cost sharing obligations up and down the income scale and across different segments of our population so that everyone has incentives to seek care at the right time and place.
The value of the commission is that it takes these difficult decisions out of the political arena and places them in the hands of individuals with expertise in medicine and public health. If applied to medical assistance programs, the commission could figure out more systematically what Medicaid shouldn't be paying for so that the state can afford to pay for medically necessary services and fair and reasonable provider reimbursement levels.
Our entire nation is clamoring for real health-care reform; Utah's Legislature must reflect this consensus and lead the charge. In this election season we have an opportunity to tell our representatives that we want real change in how we pay for and manage limited health-care resources. Segregating Medicaid recipients and deciding that their needs somehow "don't count" is a losing proposition.
We will know we will have succeeded in achieving systemic health-care reform when all Utahns, regardless of income level, have access to an efficient, effective, coordinated range of services that keeps them healthy by catching minor problems before they balloon into expensive and debilitating disease.
The time to get involved is now. Not sure where to start or what to do? That part is easy. Visit www.healthpolicy project.org.
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* JUDI HILMAN is executive director of the Utah Health Policy Project.
