Managing Ohio Medicaid System

Politicians frequently insist more health care could be provided for less if doctors, hospitals and insurance companies would just improve efficiency. Only on rare occasions do public officials look in the proverbial mirror to insist on the same thing from the monumental bureaucracies that handle most government programs.

Ohio Gov. John Kasich’s administration is doing just that, however.

Medicaid, the joint state-federal program that assists low-income and disabled people with health care, is the most expensive single item in Ohio’s budget. Each year the system doles out $18 billion.

But in Ohio, the system is managed by six different state agencies. Medicaid spending on mental health is overseen by one arm of government, while that to fight drug addiction is handled by another. Disabled Medicaid clients are helped by yet another agency, while older people are watched over by a fourth.

Obviously, that leads to overlapping responsibilities, duplicative spending and other inefficiencies. It is as if a physician perfectly qualified to handle geriatric patients with disabilities insisted they see him for some services and another doctor for others.

Analysts studying the so-called system in 2005-06 recommended Medicaid management be handled by a single agency in Ohio. Until Kasich took office, the suggestion was not acted upon. Now, however, the governor plans to consolidate Medicaid programs under a single state agency. He hopes the changeover can be completed in about two years.

Obviously, breaking up then repackaging Medicaid programs in six different agencies will be quite a task. No doubt there will be some opposition from those who insist “specialists” in Medicaid administration can provide better services.

Don’t believe it. Kasich’s plan will retain specialists but, in contrast with the past, they will work under one agency – and will provide services in a coordinated rather than fragmented manner.

It is an excellent idea that should have been implemented years ago. Kasich is right to order that consolidation proceed.