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Matthew S. Holland: The collision between education and Medicaid

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  • What in Tucket? Provo, UT
    March 1, 2011 5:08 p.m.

    Medicaid should have their own clinics. Education has become much too expensive. It is on a bubble that will break. Online education is the wave of the future. If you can get a calculus course online for less than $100 why pay $5,000 at a university. When prices went up over a few years 100% education went up 400%. All due to student grants and subsidies.

  • Pete1215 Lafayette, IN
    March 1, 2011 10:42 a.m.

    Universities are in the midst of status wars. Those in status wars have no definition for "enough". Sponsored research is 87% dependent upon government grants. So universities are massively dependent on public funds because they are not showing restraint.

    Medicare is a ponzi scheme. But math will prevail. We can either manage things, or suffer the effects of not doing so.

  • Screwdriver Casa Grande, AZ
    March 1, 2011 1:34 a.m.

    This is still a false comaprison. You may as well say that the state highway budget and education are colliding.

    Why not the money we spend on cheese and medicaid are colliding?

    Meicaid is a separate fund with a completely purposed deduction from our paychecks. Keep your grubby hands off it.

  • libertarian Cedar City, UT
    Feb. 28, 2011 7:21 p.m.

    Higher education has grown into a self-perpetuating scam that needs to be brought under control. Nearly all high school grads are now encouraged/pushed into pursuing a "degree" even though a high percentage are doomed to fail. They take out loans that burden them for the rest of their lives. Even with a "degree" these days, many are still unable to find a job that will pay the loans. Employers play along by only hiring those with "degrees" regardless how much experience or natural talent can be shown. This country was the strongest when the skilled trades were vibrant and we produced our own goods. Now everyone wants a "white collar" job and no one wants to get their hands dirty. College should be reserved for those that need and will truly benefit from it and those that won't benefit should be able to find their place in a PRODUCTIVE society, without need for "a piece of paper".

  • Tommy2Shoes Lehi, UT
    Feb. 28, 2011 4:28 p.m.

    There are 29,000 students at UNLV. Raise tuition by $2000 and you raise 58,000,000 dollars. One report showed current tuition and fees around $5500. Therefore, new rate is $7500. Univ of Colorado rate was about $8,500. Univ of Utah was about $6,300. USU was about $5,200 and UVU was about $4,300. This instate only rates. Probably should raise Utah rates much higher. About 76,000 students attend these three Utah Universities. Every $1,000 increase raises $76,000,000 to pay for their education. We should never compromise the health of our poorer residents. Maybe ER should do a triage and send them to instacare when non-emergency cases show up.

  • RanchHand Huntsville, UT
    Feb. 28, 2011 2:18 p.m.

    Of what worth is a good education if you have not the health to enjoy it?

  • Roller Gunnison, UT
    Feb. 28, 2011 10:06 a.m.

    As a physician who practices emergency medicine and works in an office clinic as well, I would like to comment on the medicaid issue: it is out of control. Frequently when I am on call for the ER and still having office hours, someone will come into our small ER, who is on medicaid, and demand to be seen for a minor ailment. They treat the ER as their own personal instacare. If someone is sick I will always see them in my office. These people never call the office, they just show up at the ER. These are the same people who bring themselves and their children to the ER at all hours of the night because it is convenient, not because it is a necessity. Nothing in life should be free. These people have cell phones, smoke cigarettes, have car payments. At least they could pay the equivalent of a weeks' supply of cigarettes to be seen in the ER.

  • Redshirt1701 Deep Space 9, Ut
    Feb. 28, 2011 8:43 a.m.

    To "Radical Moderate | 10:21 p.m." go and dig deeper.

    FYI, tort reform has proven to cut the cost of malpractice insurance. This is a significant cost for doctors involved in high risk specialities, such as surgeons, OB/GYNs, ER doctors, and other high risk specialties. Malpractice can range from $70,000/yr to $500,000/yr, depending on what the doctor does.

    Allowing companies to sell across state borders essentially creates larger insurance pools. This is one feature that the Federal Government wants for their own program. It lowers the cost by allowing companies to create larger pools.

    There are other proposals, keep digging, and see what you can find.

  • Abi Adams West Jordan, Utah
    Feb. 28, 2011 6:57 a.m.

    President Young has articulated the need for investment in higher education. At a very fundamental level, Medicaid is also an investment in our state's future. Children make up the majority of the people on Medicaid. 15% of the children in the state are on Medicaid. These children need the preventative medical and dental care from Medicaid to make sure they are healthy and ready to learn in elementary school, junior high, and high school.

  • Screwdriver Casa Grande, AZ
    Feb. 28, 2011 6:44 a.m.

    Medicaid is not ineficient. Medicaid runs on only 2% of overhead costs. Compare that to for-profit insurance companies that have 25% overhead costs.

    There's no comparison. Stop making things up.

  • Radical Moderate West Jordan, UT
    Feb. 27, 2011 10:21 p.m.

    RedShirt: The question was "What ideas" have the Republicans proposed. I know of two -- limit Tort awards (which is a reform of the legal system, not the healthcare system) and allow insurance companies to operate across state lines while giving the oversight power to the states (make insurance companies bigger and have them regulated by 50 different systems instead of just one). If these are the only two ideas, I fail to see how they will have much impact. In my opinion, insurance companies seem to be the one entity that is doing extremely well in the current market. I'm not sure that making them more powerful is going to help at all. And malpractice costs are what, about 5 percent of the total. Not a lot there, either. So once again, what ideas?

  • Considering Stockton, UT
    Feb. 27, 2011 8:24 p.m.

    This article makes great points about medicare. And it offers much needed observations about entitlement mentality. Unfortunately, it fails to address the entitlement mentality among students and college faculty as well. And too many of the comments here are yet additional examples of entitlement.

    "Tax 'the rich'. They can afford it."

    "Cut defense, I don't like, but don't touch my favored programs."

    Here is something I'd love to see from everyone who claims some right to dictate how much I pay in taxes or even how those taxes are spent:

    Tell us what YOU paid in taxes.

    I'm a little slow this year on taxes. But for 2009 here is MY breakdown:

    Federal income taxes took 11.5% of my GROSS income.
    Social Security and Medicaid took another 8% combined (plus the 8% from my employer I never see).
    And Utah State income tax was 4.7% of my gross income.

    That is nearly 25% of my gross income. Plus property, sales, gas, and other taxes.

    That is after I gave some 15% to charity.

    Any tax and spend types willing to put up what YOUR tax (and charitable giving) numbers are?

  • Howard Beal Provo, UT
    Feb. 27, 2011 6:07 p.m.

    The real problem is that both health care costs and higher ed costs are wildly out of control.

  • RedShirt USS Enterprise, UT
    Feb. 27, 2011 5:19 p.m.

    TO "NeilT | 9:40 a.m. " you ask where the conservatives are? Guess what, they have proposed ideas that will actually cut the cost of care.

    The HC bill that was passed will increase the cost of healthcare in multiple ways. First, it adds people to insurance rolls without adding doctors. Thus doctors can charge a premium.

    Second, it adds mandates to insurance. Every mandate, no matter how small, adds a cost. How much more expensive do you think insurance will be once you are able to sign up for insurace the day after getting diagnosed with Cancer?

    Third, they increased taxes on medical device companies. This makes medical equipment more expensive.

    So, tell us, how does making insurance and care more expensive help lower the cost?

  • timpClimber Provo, UT
    Feb. 27, 2011 5:14 p.m.

    Three problems have to addressed if we are to have a reasonable cost and quality education.

    Too many students are not prepared for college courses. The acceptance standards have to be raised and students who can not or will not prepare should not be accepted. This will reduce the remedial programs that cost more than regular programs.

    Divide college faulty into teaching and research status. Teachers are paid for teaching. Researchers have to raise there own salary through grants. Faculty tenure must be renewed every four years.

    Make all state schools part of one system. Each campus would have a specialty so you can cut redundant programs or just two years then transfer. Duplicating expensive upper class labs and facilities would reduce our costs significantly.

  • Screwdriver Casa Grande, AZ
    Feb. 27, 2011 4:25 p.m.

    This is a false argument. Medicare and SS are funded by separate payroll deductions for that purpose. Nobody has the right to redirect those funds. But SS and medicare funds seem to be a big pot of gold the republicans want to bust into.

    There are no payroll deductions for education. They are funded by property taxes and those funds should not ever fund medicare.

  • Ripsnorter Murray, Utah
    Feb. 27, 2011 3:47 p.m.

    For better than 20 years the price of higher education has outpaced the rate of inflation.

    There's a number of reasons why, some of which may be more or less true at UVU:

    1). Research is super expensive.
    2). Much of the professoriate doesn't teach very many hours.
    3). There's more administrative personnel per student now than ever.
    4). Cheap money in the form of student loans has students chasing education with their dollars.
    5). Potentially cheaper alternatives like online only education or for-profit institutions remain outside the mainstream and unrespected. (I say potentially cheaper because we all know how expensive colleges like the University of Phoenix are).
    6). College campuses are more luxe than they were 50 years ago and offer students more non-education-related amenities.

    President Holland needs to look hard inwardly and ask, how can we educate students less expensively before he starts eying other government programs like Medicaid.

  • christoph Brigham City, UT
    Feb. 27, 2011 12:54 p.m.

    I would like to hear Mr. Holland's opinion on the costs of the Iraq war. And if he had to choose between war and fixing health care, I would like to know which one he would choose. With his love of the country of Israel, I think I know which one he would choose, but I would like him to come right out and say it publicly.

  • FDRfan Sugar City, ID
    Feb. 27, 2011 12:24 p.m.

    In a letter from Samuel Adams to John Adams (written 1790) the following comments were made: Such an age may afford at least a flattering expectation that nations, as well as individuals, will view the utility of universal education in so strong a light as to induce sufficient national patronage and support. will draw together the sons of the rich and poor, among whom it makes no distinction. Education inures men to thinking and reflection, to reasoning and demonstration. It discovers to them the moral and religious duties they owe to God, their country and to all mankind.
    Surely, Utah of all states, will not support an education system where the people began to be distinguished by ranks, according to their riches and their chances for learning; yea, some were ignorant because of their poverty, and others did receive great learning because of their riches.

  • TwoCents Cedar City, UT
    Feb. 27, 2011 11:53 a.m.

    @ NeilT

    Spot on. Want to talk about entitlement. Americans, ALL Americans feel 'entitled' to receive medical care because we live in a country with good medical resources. When you get a new job that you worked hard to get don't you feel 'entitled' to finally receive those benefits that typically come with that level of work? What if it wasn't there? What if employers didn't provide that resource and you had to fend for yourself. Would you just shrug it off and say "well I guess I didn't get it and that's just life." No, you'd fight for a way to have access to it.

    What we are seeing is not necessarily entitlement. It's people fighting for their health and their lives. Now the way the government is handling it right now may not be ideal, but it's not the peoples fault. It is the options that are available.

  • The Real Maverick Orem, UT
    Feb. 27, 2011 11:38 a.m.

    How can we continue to give billions in foreign aid and trillions in wars while policing the whole world and cut domestic programs which benefit our own people?

    Let Asia and Europe defend themselves!

    Get us out of Iraq and Afghanistan.

    Eliminate the tax cuts for the wealthiest 1%, they don't need them. Cut the subsidizes for oil companies (who are making record profits).

    Problem solved.

  • FDRfan Sugar City, ID
    Feb. 27, 2011 11:34 a.m.

    Invisible hand.
    Medicaid recipients usually have to go to emergency rooms because doctors won't see them. A $50.00 charge becomes a $5,000 expense to tax payers.
    Solution: Romneycare.

  • peter Alpine, UT
    Feb. 27, 2011 10:41 a.m.

    Before considering a cut to domestic programs, cut foreign aid.

  • Invisible Hand Provo, UT
    Feb. 27, 2011 9:45 a.m.

    Medicaid as it is currently run is wildly inefficient. The reason it is so expensive is the beneficiaries have every incentive to go see the doctor for any minor ailment. Introduce even a small copay and we would see the cost of Medicaid drop significantly.

  • NeilT Clearfield, UT
    Feb. 27, 2011 9:40 a.m.

    Once again the core issued is ignored. Health care costs are the problem. A close personal friend is fighting cancer similiar to Atty Gen. Shurtleff. A once a month shot costs $5,000.00. My friend is a Ph.D. with a good income. He is worried what would happen if he lost his health insurance. Many are worried about hyper-inflation. We already have it in the health care industry. Why conservatives are so unwilling to address the health care crisis is mind boggling. I for one am sick of living in a country where people have to beg for charity health care because a loved one needs an operation or medical care that insurance won't cover or they are uninsured due to unemployment or a pre-existing condition. There are people in Canada who refuse to visit the U.S. out of fear. Fear that an accident here or emergency medical care would leave them bankrupt. The real entitlement problem is the medical profession and out of control costs.

  • Dale G SLC, ut
    Feb. 27, 2011 9:14 a.m.

    Well, that's what you expect from someone feeding at the public trough: Don't cut my paycheck -- cut somebody's life saving treatments instead!

  • working class Salt Lake City, UT
    Feb. 27, 2011 9:12 a.m.

    At first pop it seems somewhat arbitrary to select two government programs and have them square off. One could select a number of different government measures to compare to higher eduction. Dr. Holland gets no opposition from me in his enthusiasm for higher ed. But in the current climate if one substitutes education funding at the expense of medicaid, the opportunity cost incurred amounts to many human lives. This hardly seems reasonable.

    As to the presumed culture of entitlement, this is more a culture of survival or the attempt to survive in a treacherous environment. If Dr. Holland cares about higher ed AND health care he should support a single payer health system of some kind with teeth to contain costs and fairly distribute health services. Contrary to what Holland thinks, most people do not want government taking care of them - what they want is health care they can afford so they can get on making a contribution to their society.

  • scambuster American Fork, UT
    Feb. 27, 2011 8:54 a.m.

    Is Medicaid the problem or is the cost of health care? As smart as we are, we cannot think our way out of outrageous hospital bills.

    Eight years ago I had five stitches given at the emergency room (it was after the Instacare had CLOSED for the night). The cost: $1,000. That was eight years ago. I could only imagine what that would cost now. Unless we reign in ludicrous medical costs, we will either have to spend more money on health care or the majority of the population can expect to have an average life expectancy of about 50 years. The best way to control medicaid is to find out why medical costs are increasing at a pace of 3 to 5 times the rate of inflation and think of solutions.

  • KDave Moab, UT
    Feb. 27, 2011 8:07 a.m.

    I do not understand why Medicaid is called an entitlement. It is welfare plain and simple.

  • JMT Springville, UT
    Feb. 27, 2011 8:04 a.m.

    I really appreciate President Holland's comments and agree. I would also suggest that Higher Education in general look into the mirror. The costs of education in America has outstripped inflation by roughly double, every year for a few decades now. While inflation has remained steady 2-3% the cost of higher education has remained steady at 8% or more.

    I have videos, etc of higher education after World War Two. Such growth in student population with the demans of the Greatest Generation, Universities set up classes in military, metal shacks. In fact, as of a few years ago BYU still had one near the Wilkinson Center. It is an example of Higher Education getting it done. Now, we are entrenched in a linear thought process about delivery.

    To bring both worlds together (spiraling costs and need of 66% graduation needs) Higher Education needs to dramatically change their delivery. Virtual education needs to become the norm; Associate Degrees need to be more focused, almost a modern certificate of skills, etc.

    Lead on, you are halfway there!

  • FDRfan Sugar City, ID
    Feb. 27, 2011 6:48 a.m.

    Whose money is it? All of the ills of our current global society are blamed on the shortage of money. The fact is that there is plenty to spare.Consider the words of Thomas Paine.
    Civilization, therefore, or that which is so called, has operated two ways: to make one part of society more affluent, and the other more wretched, than would have been the lot of either in a natural state.
    Separate an individual from society, and give him an island or a continent to possess, and he cannot acquire personal property. He cannot be rich. So inseparably are the means connected with the end, in all cases, that where the former do not exist the latter cannot be obtained. All accumulation, therefore, of personal property, beyond what a mans own hands produce, is derived to him by living in society; and he owes on every principle of justice, of gratitude, and of civilization, a part of that accumulation back again to society from whence the whole came. Its the distribution of wealth that is the problem.

  • My2Cents Kearns, UT
    Feb. 27, 2011 4:18 a.m.

    The Utah braggards are out again, bragging about how well they can manipulate the economy figures to make us look superior. Utah legislators haven't been able to accept the fact that federal funds are drying up, pork funds are minimal and more controlled, Medicaid and education funding is a burden rather with no tax revenue to support it. And the slave labor jobs is Utah cannot support tax dependent government, education, or health care.

    The truth is that Utah legislators still have their heads buried in the sand and refuse to accept how critically corrupt and disheveled the economy of Utah is. Utah legislators are adept at manipulating numbers to falsify information and to use that falsified information to plan a budget. A very critical mistake for the future of this state. We need a reality government, one that isn't mentally and vision impaired.