End Medicaid’s Mission Creep | National Review

[u/coldnorthwz]

https://www.nationalreview.com/2024/12/end-medicaids-mission-creep/

[u/tejanx]

I’m not sure I agree with the thesis:

Instead of focusing on critical medical care, Medicaid has become a vehicle for funding nonmedical services such as housing, food, and transportation — areas traditionally managed by other public welfare programs. This mission creep not only dilutes Medicaid’s effectiveness but also deepens state dependency on federal dollars, threatening both fiscal responsibility and state sovereignty

Part of the reason Medicaid dollars have flowed to things like transportation is because it allows for better coordination of services—preventive care appointments and transportation to and from those services can be managed by one entity, rather than being siloed across multiple agencies with disparate priorities and modes of communication.

Really, what is lacking is better integration of existing services, which is what encourages the duplication in the first place.

[u/LanceArmsweak → u/tejanx]

And this is where the real government efficiency could actually come from. Integration. Not lobbing off.

We could really benefit from better systems management that are synced together.

[u/Nelliell → u/LanceArmsweak]

Agreed. Better integration, better cooperation between departments. How many mishaps and unnecessary spending has occurred because one hand didn't know what the other hand was doing?

[u/redditthrowaway1294 → u/Nelliell]

As somebody who works in government and has to regularly communicate with other parts of government, this is absolutely not something that gets better going from private to public.
Maybe there is a way to make the integration better, but it's not guaranteed to get better just by bringing the private end points under public control instead.