Medicaid, by intention, is one of the greatest social systems our nation has devised. A government is supposed to care for its people in need and Medicaid was to do just that. But, as all taxpayers know too well, something is amiss. New York is besieged by a completely unmanageable and ever-growing system of its own design. Our brand of Medicaid was spawned by a very liberal, quasi-socialist downstate political system that strived to better the poorest sections of New York City. This caused overzealousness to reign supreme in an effort to coddle such a huge population, creating a Medicaid package that is intrinsically too lenient and generous.

Such a system requires substantial funding to ensure its effectiveness. Looking at this situation from a localized standpoint, Niagara County finds 9% of its population under the care of Medicaid. This, combined with the State’s base rate, requires that one-eighth of our sales tax be specifically earmarked for Medicaid expenses while over 53% of the total property tax levy be thrown at the same. This unrepentant expenditure places serious hurt upon local businesses and taxpayers alike. In a strange twist of irony, this taxation rapes the pocketbooks of those who can least afford it…those who need Medicaid.

The most disconcerting part of this whole mess is the fact that taxpayers, public interest groups and politicians all to a man have known for quite some time that the system is broken. Thing is, few elected officials have been creative, aggressive or powerful enough to initiate change. It’s almost as if Medicaid reform has historically been perceived as "politically-incorrect" based upon the power of the Downstate constituency and its socialist leanings.

Thankfully, this fear of incorrectness has lessened of late. In the past year the need for serious Medicaid Reform has become a very hot topic in the press and amongst local levels of government throughout the State. Adding fuel to the fire is similar commentary from the federal government. Because of this, solid, noteworthy thoughts on reform have come to the forefront and more Albany politicos are now jumping on the reform bandwagon.

One legislator, WNY’s own Robin Schimminger, has been a steadfast proponent of Medicaid reform, even before its recent ascension to haut couture. Earlier this year he introduced a handful of common sense bills for the 2005-2006 legislative session. These were created not from some Albany think-tank, but from feedback and ideas offered to him by many of his constituents and even the Niagara County Legislature itself.

Among Schimminger’s reform items are numerous changes to eligibility definitions. He has suggested the State institute a 90-day residency requirement. This plan is simple yet effective. It would save considerable waste by closing our borders to the morbid droves of people who travel to our state only to partake of our services. He has also suggested adding asset allowances for categories of eligibility where none currently exist and disallowing asset shelters, both of which would ultimately kick out many Middle Classers who are dirtily pulling services from a system that was designed to aid the poor.

Schimminger - echoing the concern of many public sector employees across the State - has also introduced a great bill that requires equality in health care. Medicaid offers many frills (dental, audiology, psychology) that most private health insurances don’t. By leveling the playing field and placing Medicaid at par with the Real World through elimination of these frills, taxpayers will be saved millions.

Another of Schimminger’s bills promotes long-term health care insurance through increased tax exemption. The reasoning is, if more people would prepare for their later years and invest in LTHCI (which does offer better benefits than Medicaid), they would save the Medicaid system countless dollars as long term care is the definitely the largest load placed upon Medicaid.

These bills and others have garnished some support from Senators and Assemblyfolk alike. Taxpayers can only hope that this support for Schimminger’s bills continues to grow and gets Albany moving in regards to fixing our broken Medicaid system. The old way of doing business – throwing money at the problem – will never fix Medicaid. We’re already paying dearly for it and there’s only so much to give.

Were we to continue at the current rate, all of New York would one day need Medicaid.