Today South Carolina, tomorrow the Country!

South Carolina lawmakers are hoping to change their Medicaid plan into a kind of voucher system: Here's the money you're entitled to based on your age and health-- Go spend it however you want! The program's proponents say it will put patients back in charge of their own care, while creating significant cost savings for the government. Sound like a Win-Win situation? Of course it does. But there are some assumptions being made here: For example, when reporters bring up the scenario of someone with major health problems, the stock response is that person's best option is to purchase health insurance with their health-care money.

That sounds great until I think about the last time I looked into purchasing Health insurance for myself: Because of my cerebral palsy, most insurers rejected me. The state-subsidized insurer who could not reject me offered a bare-bones policy that would have made most of my major medical expenses (wheelchairs, artificial limbs, etc) my responsibility, AND their premium was twice that of the other companies. Forgive my skepticism, but I don't believe they'd be offering me a voucher for _that_ much over the baseline.

Of Course South Carolina wants to reduce the costs associated with Medicaid. But keep in mind, they also want to keep their cushy relationships with big-business healthcare. This Medicaid reform plan is a sweetly stated attempt to strip the program down to a level of well-baby, once-a-year-checkup coverage on one end and ventillator, ethics-committee-tango on the other. I've got to find a way to get loud about this because if South Carolinians allow it, every state in the union will be lining up.