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Commentary

Son of Sanford
Wall Street Journal, 8-23-05

The Journal has been closely following South Carolina Governor Mark Sanford’s efforts to bring market-based reforms to the state’s Medicaid program. As happened with welfare reform, the prospective of meaningful Medicaid reform is drawing howls of protest and predictions of Sturm und Drang that would bring tears to Wagner’s eyes.

[Gov. Sanford wants] to take the $4 billion spent each year in his state on Medicaid and create "personal health accounts" that would be used to buy private health insurance. The details are still being worked out, and the amount each individual would receive would vary by age and other factors. But in rough outline individuals would receive about what Medicaid spends on them now—$4,000 for most adults. Anyone who buys insurance for less would be able to pocket the difference for other health-care needs. …
All of this is earning Mr. Sanford's proposals the usual hazing as cruel and heartless. Those who favor the entitlement status quo—led by the Beltway's Center for Budget and Policy Priorities—are warning that "children would lose access to needed health services" and that the accounts wouldn't pay for all the care adults need. It's true that Mr. Sanford wants to lower the age—to 18 from 21 –at which eligibility ends for childhood benefits. But last we checked a 20-year-old wasn't a child. And the reform would also mandate that any health insurance purchased with Medicaid money provide at least the benefits that are currently offered. The health care for many is likely to improve.

Rachel Klein of Families USA, another liberal advocacy group, probably gave the real game away when she called the Sanford proposals part of a "dangerous trend." What these liberals really fear is that the South Carolina experiment will succeed, that personal health accounts will prove to be popular among the poor themselves and that the constituency for government health care will decline.

Liberal or conservative, the country is in dire need of fresh thinking for its entitlement programs: Medicare, Medicaid, and Social Security. Governor Sanford ought to be commended for bucking the status quo and trying a new approach—progressive public policies, after all, can come from any ideological quarter.



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