Medicaid

I think Esmonde overstates, to some degree, the affect of Medicaid on the county budget crisis and minimizes Giambra's own mismanagement. Doesn't matter. He makes a valid point.

"The county made the payroll-and-perk cuts that come every day in corporate America. But there's more to this disease than pink-slipping Victor M. Getz can cure. The local price of Medicaid siphoned an extra $81 million from taxpayer pockets the past five years. It will suction another $40 million over the next two. Where is that money coming from? I'm ecstatic to see bloated political staffs jettisoned, keys to take-home cars turned in and 'free' cell phones turned off. We're upending a primitive political culture that sees government mainly as a jobs program.

I love that last sentence. It's right on the money.

But don't kid yourself that it will get better, that the cuts we've made loosen the high-tax stranglehold. To twist a line from the Bill Clinton era: It's the Medicaid, stupid. And it's not going away. State lawmakers blasted County Executive Joel Giambra for his budget bungling. No argument. But Albany lawmakers put us against the financial wall by making Medicaid a collection bin for every health program and perk. From drug treatment to mental health care, what other states leave to managed care we dump into Medicaid. We looked our fat self in the mirror, now Albany has to do the same. It has to stand up to special-interest muscle: The hospitals, health care worker unions, drug companies and everybody else overfed by the Medicaid beast. If it doesn't happen, we will keep paying more taxes for less. With parks already gone, medical clinics shut and snowplows sidelined, I'd hate to see what less looks like. "

Well, we don't really need County government to begin with. Let the state pay for its own bloated, diamond-encrusted Medicaid system. Swanick says:

"This (budget) discussion will continue," Swanick said. "But if the state doesn't do something about Medicaid, next year it will be about closing the doors."

So stop your whinging and close them, already.