Print edition: 
TOPEKA — The state's Medicaid program faces a bleak future — unless reforms drive down costs and people begin making healthier lifestyle choices, Lt. Gov. Jeff Colyer said Monday.
Without changes, rapidly growing Medicaid costs will overwhelm the state and affect funding for things such as K-12 education, he told the joint legislative committee on health policy oversight.
Medicaid, the health program for low-income residents, should do what some insurance companies do and reward patients who quit smoking, work their way out of obesity and take their medicine, he said. And the 40-year-old program should work to transition users to private health insurance.
"This (Medicaid) is the most complex thing I've seen in government," said Colyer, a physician. "And we aren't going to fix it in one year."
Colyer's call for reform and improved services comes as federal funding is expected to decrease. Some say Colyer's descriptions of cutting costs and improving services are too rosy.
"I don't see how it can possibly work in any way, shape or form," said Sen. Roger Reitz, R-Manhattan, also a physician.
Reitz works with patients who need a lot of care. If they don't have money to pay for proper care, they'll be in emergency rooms, which is part of the disaster the state is trying to avoid, he said.
"You're never going to cut medical costs down; you know that," Reitz said to Colyer.
Colyer said federal cuts to Medicaid proposed by President Obama on Monday translate to roughly $720 million in reductions to Kansas over several years.
He said ideas gathered from more than 1,200 people in four public forums on Medicaid reform this summer — plus concepts used in other states — show Kansas needs to create a safety net for its neediest people. It needs a system that links outcomes to price, provides employers with incentives to hire people with disabilities and provides people to coordinate patients' care.
Reitz said there's no way the state can improve while drastically cutting funds without embellishing services.
"It won't happen, it can't happen," he said. "If it does you're going to have people marching on the Statehouse, tearing the place apart, saying, 'We can't go on this way. Try something else.' "
Colyer disagreed.
"I believe economic forces do work and do force us into better patient care," he said. He cited laptop computers as an example, saying they once cost thousands of dollars and now are cheaper and have better technology.
Colyer said the state can save money by having someone coordinate health care for patients with serious problems.
"If we can navigate them through, you can save money on not institutionalizing them," he said.
Reitz said he and other doctors already help their patients manage their care.
