What I would do about Medicaid is not what I would do about health care. In my view, because those in need of expensive care, and those who do not want to pay for them, are free to move across state borders, health care is a national problem with a national solution (see here).
Any state that attempts to provide universal care for its residents will end up providing universal care for all Americans – until its economy collapses and it provides nothing to anyone. With regard to Medicaid, my goal is to avoid having the health care industry – with its political power and indifference to the consequences of its increasing demands – from destroying other public services and the economy of the state. Medicaid, for me, is a fiscal issue, not a health care issue, and my goal is to continue to get necessary health care without paying twice as much as everyone else. That is different from the current fiscal goal – to pay as much as possible in for as little as possible in exchange for political support. The current situation is a product of incentives – the state government gets to hand out money to its supporters, but other governments are forced to pay much of the cost and impose much of the sacrifice. My proposal is to change the incentives.
