Broaden the con­ver­sa­tion

The Oklahoman (Sunday) - - OPINION -

“Med­i­caid re­form could ben­e­fit Ok­la­homa” (Our Views, Jan. 8) is a thought­ful and timely opin­ion piece as the Leg­is­la­ture pre­pares for a new ses­sion where this vex­ing pub­lic pol­icy chal­lenge is sure to re­main a top leg­isla­tive ini­tia­tive. As the former sec­re­tary of health and an Ok­la­homa state se­na­tor, I know first-hand how dif­fi­cult it is to re­form our health sys­tem.

I do want to of­fer a counter view. The Ok­la­homa Health Care Au­thor­ity has done heroic work to keep costs un­der con­trol. To do an ap­ples-to-ap­ples as­sess­ment, the edi­to­rial’s fig­ures ought to in­clude en­roll­ment gain and the shift­ing state/fed­eral match­ing bur­den. From 2008 to 2016, state spend­ing in­creased at a com­pound an­nual growth rate of 6.65 per­cent. If you in­clude the fact that en­roll­ment in­creased dur­ing that same time pe­riod, from just un­der 800,000 en­rollees to just over 1 mil­lion, an­nual per-mem­ber costs have only in­creased .56 per­cent. This es­sen­tially flat rate of growth in per-Med­i­caid en­rollee costs are vastly su­pe­rior to the health in­fla­tion in per­per­son costs com­mon among pri­vate­sec­tor com­mer­cial plans.

Now is in­deed a good time to as­sess Med­i­caid re­form, es­pe­cially given the na­tional con­ver­sa­tion. But I hope the con­ver­sa­tion in­cludes our en­tire state health sys­tem as well. The sur­pris­ing fact is that with re­spect to cost con­tain­ment, the Ok­la­homa Health Care Au­thor­ity has much to teach other stake­hold­ers.

Tom Adel­son, Tulsa

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