The Taboo Topic

I just finished reading an article by the citizens research council of Michigan r/t the Michigan budget fix for 2007; and what we can expect for 2008. The numbers, prospects and outcomes for next year make we want to pack my bag and head south; or west. I want to be in one of those states where the tax payers are getting money back, due to their state's excess of funds. (Yes, over 40 states have fund excess this year).

As someone who works within the Michigan Medicaid system, I am still scratching my head in wonder as to why Michigan has not looked to asset recovery as one remedy to the medicaid funding crisis. Yes it is a political hot button. Who wants to have their name on legislation that promotes taking assets from the frail and elderly to pay their medical bills? That would/could be career suicide for anyone who would like to continue their pursuit of a political career. As someone who works on the provider side, I recognize the negative of for profit businesses promoting such an item as well. Who wants to be known as the "place" that wants to take all of your money. It could become a corporate "greed" connotation being attached to your logo. Instead, everyone from state leaders, to provider leadership avoid this conversation and never bring it to the table as a solution.

Yet, Michigan remains a renegade state in regard to asset recovery as one way to help fund the medicaid costs of elder care. We allow individuals to qualify for medicaid coverage, and keep their homes. Homes valued way above the norm for the average Michigan resident are still an allowed asset. In most states, if the medicaid applicant does not have a surviving spouse, the home has a medicaid lien placed on it; or a reverse mortgage is set up. Some state's even require the home to be sold and the money to be used for care prior to picking up the medicaid care tab. Yet in other states, even with a surviving spouse, the home may have a lien placed on it; and at the death of the spouse, or the sale of the home; the state recovers their money first.

At what point are we going to recognize that this program is one "good and fair" way to collect or offset the increasing burden of medicaid on the state of Michigan? What special interest group, or need are we protecting by not seeking some recovery of money spent for care? If we want examples of where it works and works well, we should go back to the 40 states with fund excess; review their medicaid policies and programs then adopt the very best for our state.

Think about what good corporations and businesses do when someone has a new idea. In my profession, if someone has a great program with excellent outcomes; we study it; tweak it and make it work for us. But that might be to much like business think for our leadership to do; instead, we would rather debate and maintain hard lines of party rhetoric than to look at policies and programs that work.