Posted by R. Neal

The federal government has approved Florida's Medicaid waiver, effectively privatizing Medicaid in Florida:

The federal government approved Florida's plan to shift thousands of Medicaid patients into managed care, an unprecedented pilot program that could be expanded to include millions of poor and elderly people covered under the system.

Gov. Jeb Bush and other proponents say transferring responsibility to private health plans would provide better care, and control the escalating costs of the health insurance program.

Unprecedented? We've had a similar program in Tennessee for years, although not quite as radical as complete privatization. As for providing better care and controlling costs, perhaps Jeb ought to ask Tennessee Gov. Phil Bredesen how that's working out.

Opponents are skeptical:

AARP, the group formerly known as the American Association of Retired Persons, questioned the state's ability to implement such a large program.

"The administration wishes to trust big private insurance companies to handle this vital task," AARP state director Bentley Lipscomb said in a statement. "Someone needs to ask the hard questions about how Florida's least fortunate will fare."

They could simply ask some of the 120,000 people in Tennessee who are now without health insurance how they are faring.

TennCare was supposed to be a grand experiment to prove that a managed care system could cover more people at lower costs. At its peak, nearly 1/4th of the population of Tennessee was on the program. Clearly that was not sustainable. But is kicking these people to the curb, many of them working poor, really the best solution?

When will a Governor stand up and try something truly bold and visionary, such as a single-payer universal health insurance program that covers everybody in their state, funded by all the money previously flowing from Medicaid and private insurance policies? Now that would be unprecedented.

OK, then.