“This is not our priority right now.” That was the answer from the Louisiana Department of Health (LDH) to the Senate Finance Committee when pressed about why they had not moved forward with the implementation of Managed Medicaid Long Term Care in Louisiana. From their perspective, implementing a reform that offers a potential savings to taxpayers of more than $200 million per year must not be of near as much importance as is raising and spending billions on the growth of the welfare state.

Beside the potential savings offered by Managed Care, the Finance Committee also heard that huge savings could be derived from more aggressive pursuit of Medicaid fraud. The Federal government has published data indicating that the national average of Medicaid fraud is about 12%. When I pressed the Attorney General’s staff, they testified that in their estimation Louisiana currently only prosecutes fraud at a rate of about 1%. At the same time LDH testified that their focus is on training not fraud recovery.

For any recovered fraud there is nearly a 30% savings directly to the state. In today’s overheated world driven by massive Medicaid expansion that could represent hundreds of millions per year! Let’s be conservative, if we recover fraud at only a rate of 6%, half the national average, that could be $180 million per year. Training to watch for fraud is important, collecting misbegotten gains back for the taxpayer is more important. A simple person would ask “Why not do both at the same time?”

Call me a cynic, but the Administration’s focus on raising taxes must be a whole lot more desirable to them than making crooks pay up and of being a good steward of the peoples’ money! Or, is it that the political game is really to build the welfare state so fast and so deep that it will be impossible to reverse the damage to the state even when the inevitable collapse comes?

So, on behalf of the taxpayers, I insist that Medicaid Managed Care reform and a focus on Medicaid Fraud be placed as top priorities that must be accomplished before the Administration be allowed to pursue its perennial favorites, raising taxes and spending like there is no tomorrow. Amazingly if they would do just those two things we could solve our state’s entire budgetary shortfall for this year. We could fund TOPS, we could fund mental health, we could fund higher education!

Priorities? Mine are simple, we must deliver government services effectively and efficiently. Apparently the Administration’s priorities are focused elsewhere. It seems that the growth of the entitlement regime’ is of far more importance than being a careful steward of taxpayer’s dollars.