Catching up on my e-mail, I ran across this release from our friend Wesley over with the Senate Republicans:
Senate passes bill giving DHHS budget flexibility
The state Department of Health and Human Services needs to crawl out of a $228 million hole for this fiscal year, alone. Next year, deficit estimates top $500 million. But, it doesn’t have to stay this way. That’s why Senate Republicans led the fight today to pass S. 434 — it removes budgetary constraints on the actions of agency director Tony Keck and gives him and his department more flexibility as it comes to this fiscal crisis.
The legislation, chief sponsored by Senate Majority Leader Harvey Peeler and cosponsored by Senators Kevin Bryant and Lee Bright, requires the ability to purchase generic drugs instead of more expensive name brands. Most importantly, it repeals part of a proviso that stopped any DHHS director from modifying the schedule by which doctors and hospitals were paid through the state’s administration of Medicaid.
“This bill is all about untying Mr. Keck’s hands and allowing him to do his job as effectively as he can,” Peeler said following the vote. “That doesn’t mean he has to cut programs, it means he can cut. With such a huge deficit, we need Keck to be running his own agency, not micromanaged by the legislature.”
The bill’s passage is also seen as a win for Gov. Nikki Haley. It both invests more power to an executive branch agency and hands those reigns over to one of her recent appointments. The budgetary problems within DHHS — and Medicaid in particular — have been high on issues to address for both the governor and the legislature as they entered this session.
Keck has said that he’s looking at making health care providers modify their staffing ratios, increasing patient co-pays and taking a hard line in favor medical tort reform. Senate Republicans are ready to help him in any way possible fix the agency’s financial problems.
“Flexibility.” I like that. It reminds me of when people who want to increase taxes call what they’re doing “revenue enhancements.” When conservatives in SC want to cut spending on life-and-death essentials, they call it “flexibility.” As euphemisms go, it’s sort of breathtaking.
I especially liked this part, so I’ll repeat it:
“This bill is all about untying Mr. Keck’s hands and allowing him to do his job as effectively as he can,” Peeler said following the vote. “That doesn’t mean he has to cut programs, it means he can cut. With such a huge deficit, we need Keck to be running his own agency, not micromanaged by the legislature.”
Translation: We’re going to flat make these cuts, but we are not going to take the responsibility. That’s what the governor hired Mr. Keck to do. Interesting how sometimes, the Senate sees granting power to the executive as a good thing. Take note, boys and girls. Take pictures, and remember so you can tell your own children, because this doesn’t happen often. Normally, as Cindi wrote on Wednesday, or Legislature is “fixated… on micromanaging the most mundane minutiae of state government…”
But flexibility — that’s a good thing, right? Sounds good, anyway.
Here’s the way what the Senate did was described by a neutral party (which is why we have the MSM):
The S.C. Senate gave key approval Thursday to a bill allowing immediate cuts in state payments to doctors and hospitals that treat patients in the state-run health care program for the poor and disabled.
Gov. Nikki Haley and the Department of Health and Human Services have sought to cut those payments in order to make up part of a $225 million deficit at the state’s Medicaid agency. Agency director Tony Keck said the state could save $2.4 million between now and June 30 for every percentage point that it cuts those payments.
The bill also requires HIV, AIDS, cancer and mental-health patients to use generic drugs or get prior approval from the state’s health agency to use more expensive, non-generic drugs.
So you’ve seen it described two ways — by the perpetrators and by the news media. Now, here’s the assessment of someone at the other end of the spectrum. Samuel Tenenbaum, the head of Palmetto Health Foundation, came to my table at breakfast to make sure I knew what was going on from the perspective of health care providers. He said it’s not a fiscal issue, but a moral issue, for this reason: Cut back on payments for care, and “people will die.”
This, of course, will be dismissed by folks at the first end of the spectrum who will describe Samuel as a bleeding-heart liberal Democrat whose ox is being gored. They’ll tell him to get out there and work harder raising money for the hospital, if he’s so concerned. But you know, I don’t distrust the judgments of people who are actually involved in the complex business of paying for health care. I tend to think that they, the involved parties, more than anyone else, may actually understand the situation. Call me crazy.
Later in the day, Samuel sent me this set of more formal talking points, elaborating on his stark assessment at breakfast:
• The ProblemFormer Governor Mark Sanford originally requested $659 million to fund the Medicaid program for fiscal year 2011-12. Governor Nikki Haley and her Medicaid director Tony Keck reduced that request by over $200 million. More than half of that reduction would be made up by reducing Medicaid payments to hospitals, physicians and other healthcareproviders.• South Carolina Hospital Association ProposalSCHA member hospitals support a temporary increase in the $264 million hospital contribution to the state’s Medicaid fund as opposed to a cut in hospital provider rates.• Why contribute rather than cut?• A 10 percent reduction in the rate paid to hospitals will “save” $47 million in state funds but “cost” the state almost $170 million in federal matching funds. As Mr. Beaman has stated, a 10 percent cut for Palmetto Health will result in a $22 million loss to our system.• Over 2600 South Carolina hospital jobs will be put in jeopardy.
So there you have it, a sort of Three Bears approach — perspectives on the issue from both ends and the middle. See what you think.









