Critical Condition

The States and Health Care Politics

Last weekend, the Wall Street Journal touched on a huge and underreported story in the health-care debate: the fate of those states that spend much more than others per person on Medicare.

Some lawmakers from states with high health-care costs are also pressing House Democratic leaders for changes to the deal to ensure that their doctors and hospitals don’t see too big of a bite.

“We don’t want a study to be prepared that, even before they go into it, is slanted in a certain way,” Rep. Kathy Castor (D., Fla.) said in an interview. The Florida delegation this week raised concerns with House Speaker Nancy Pelosi about the deal that was reached.

Another issue for high-cost states is how quickly any changes to the Medicare payment structure would go into effect. When announced last Friday, the deal called for the changes to be implemented by 2013, when a public insurance option is slated to take effect under the House health-care bill.

The basis of the “savings” that are “sustainable” for the Democrats and the president are based upon the ability to move the spending curve on Medicare (as I noted here).


As August begins, it is worth repeating why this matters so much:

Medicare Spending per Enrollee

The “high-spending” states are in orange. Another way to think about those states is to see them as 174 Obama electoral votes. The only red states in 2008 from the list are Texas and Louisiana.


Medicare beneficiaries in these states, and their loved ones, have plenty of reason to wonder why their Representatives and Senators would vote to reduce the care they currently receive. Hospital employees and contractors and their families, too, have plenty of reason to wonder why members of Congress would vote to take away jobs and opportunity in their hometown. And everyone voter should wonder why this course should be pursued it will only add hundreds of billions of dollars to our already-gigantic deficit.


Eric Novack is a senior fellow in health policy for Americans for Prosperity and chairman of Arizonans for Health Care Freedom.

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