In Maggie Mahar’s post yesterday, Medicaid Needs More Than A Short-term Fix, she highlights the dire straits most state Medicaid programs are in (for example, despite a Medicaid enrollment increase of 18 percent over the past year in Arizona, the state has stopped enrolling children).

Medicaid is an out of control program that is bankrupting state and federal governments. The befits are similar to those of private insurance, but for free. The program will not allow copayments to change behavior, but without them, the systems are falling apart. Here in Connecticut, if you take a ride down to Bridgeport of Yale New Haven hospitals on a Friday afternoon and check out the ER you will see how jammed it is. Services for a majority of these people will be performed without so much as a copay. Even a copay of $5 could make a significant difference to the program. As head of Health Net Medicaid, I was sued regularly for trying to implement such ideas, but if something doesn’t change, these programs will continue to go bankrupt.