The Medicaid Mess, Continued

In a primer on Medicaid. The Wall Street Journal explains what happens when the government designs health care systems:

What specifically could help Medicaid address its long-term care costs? Nothing that lends itself to quick fixes or catchy political talking points.

One is to untangle the mess created when the elderly and disabled are covered both by state-federal Medicaid and all-federal Medicare. About 40% of all Medicaid spending goes for these "dual eligibles," as they're known. Medicare (which pays acute-care hospital bills) has an interest in keeping them out of the hospital; Medicaid saves money when they go into the hospital. The maze of conflicting incentives and overlapping rules makes coordinating care for these often chronically ill patients nearly impossible. [bold added]

Yesterday, the Obama administration released 427 pages of proposed new rules for coordinating care between various medical providers. Maybe the bureauwonks have figured it all out this time? 

More on the many problems with Medicaid here, here, and here.