Solutions: Yearly Mississippi Medicaid Deficit

There has been much published in the various media in this state regarding the Medicaid deficit in our state.  The proposals for remedying the problem are varied.  These initial solutions that have been proffered to us include a hospital “assessment” and lowering payments to physicians for services to Medicaid patients.  Those who depend solely upon Medicaid already know the difficulty of getting treatment sometimes and lowering the already dismal reimbursement (a reverse tax) will only make that problem worse.  Asking the hospitals to pay a tax might sound reasonable to some, but smaller, mostly rural hospitals that are in abundance in our state will suffer the most with some even looking at having to acquire a loan to pay this illogical tax.  The other proposal to decrease services to Medicaid recipients is not tenable either.  In the past, there were more recipients of Medicaid who did not need it; however, much has been corrected with the current system in regard to eligibility.     

If we are going to work together to figure out a way to keep our current system of providing for the healthcare for the poor, we should look at areas that actually result in greater Medicaid expenditures.  One of these areas is smoking and we have heard a lot about raising the tax on cigarettes.  This actually has become law despire Governor Barbour’s initial reluctance to pass it initially.  It would result in some quitting smoking and others not starting while providing more than enough to shore up Medicaid.  However, we must look at who is paying this tax; it will be paid by the addicted multitudes that are mostly poor and can scarcely afford it.  This will surely force some people to quit due to lack of finances to continue their habit, but then the source of revenue will decline, too. 

          Another area that few, if any, have suggested to analyze is that of the gambling problem we have hoisted upon ourselves in this state.  Many are not familiar with what gambling has done and is doing to our society.  It definitely does result in greater Medicaid expenditures which has been recognized even by the Texas GOP, to name another state’s Republican leadership that is able to see more clearly on this issue.  Casinos in Mississippi pay a 12% tax rate which is relatively small compared to other states where casinos exist, made $3 billion last year, and could easily afford to pay a little more in what we should call a casino healthcare assessment

            According to a study published in our own state by the University of Southern Mississippi in 2000, an estimated 5% of our population in 1996 were “problem” gamblers and an estimated 2% of our population have a “probable pathological” problem with gambling.  These numbers are consistent from state to state in multiple studies.  Given the over eighteen years old census estimate for 2006 at 2,165,442 people in MS, that’s 108,272 people and 43,309 people, respectively.  Every gambler with a problem costs society varying estimates in money on a yearly basis.  One study places just the pathological gambling costs at $13,586 per pathological gambler; some place it thousands of dollars higher.  Looking at just the people with a “probable pathological” problem, the costs to Mississippi society are over $588 million per year.  Gambling costs us all and not just in the counties in which it is legal.  In no matter which area of our state you live, you can read about case after case of embezzlement that didn’t used to be such a high rate.  Cash for titles businesses and pawn shops have flourished.  The poverty rate in Mississippi was just recently reported as having risen to almost 18% which is the highest in the nation.  It is a proven fact that gambling increases poverty.  Some of our leadership in this state would have us believe that gambling has helped our state so greatly in a financial sense.  Their argument doesn’t hold when all the costs of gambling are considered.  Those who care about others should not have accepted the voluntary inoculation of this insidious disease in the beginning, but we all must not accept any further encroachment of gambling into our state.  What we already have is harmful enough and will continue to cause our state to have a multitude of problems.

          Our first president, George Washington, wrote to his nephew in a letter on January 15, 1783: “The last thing I shall mention, is first of importance and that is, to avoid gaming. This is a vice which is productive of every possible evil, equally injurious to the morals and health of its votaries. It is the child of avarice, the brother of inequity, and father of mischief. It has been the ruin of many worthy families; the loss of many a man’s honor; and the cause of suicide. To all those who enter the list, it is equally fascinating; the successful gamester pushes his good fortune till it is overtaken by a reverse; the losing gamester, in hopes of retrieving past misfortunes, goes on from bad to worse; till grown desperate, he pushes at everything; and loses his all. In a word, few gain by this abominable practice (the profit, if any, being diffused) while thousands are injured.”  [The Writings of George Washington from the Original Manuscript Sources, 1745-1799, (Washington, D.C.: United States Government Printing Office, 1938), Vol. 26, p. 40]

          We should recognize the real problems where they exist and the casino’s existence contributes to poverty and to Medicaid expenditures.  The real question is whether we have enough leaders who don’t run their campaigns from casino cash, and actually do care about serving the public, to truthfully acknowledge this problem and offer a remedy to Medicaid’s problem that actually makes some sense.

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