In the 2011 fiscal year, the higher payments cost taxpayers $328 million, the ­report said. or about a $1 Billion over three years - we cannot afford this. Managed care has been in play over the last two decades. The report is not clear on who advocated the move to costly manage care and if this person will be disciplined and made to pay for this mistake. Why are we continuing to pay insurers to administer and make profits on these managed care programs? put everyone back on traditional plans immediately. We can thank Gov Patrick.

And the purpose of this Editorial that pretends to be "News" IS????----As a rule of thumb, Globe's "solution" to wasteful big government spending, regulations, and bureaucracy is....MORE wasteful big ogvernment spending, regulations, and bureaucracy.

The reason some hospitals have strong brand leverage is because the patients think that those hospitals are better. The "name brand" hospitals serve affluent suburbanites. People on Medicaid are poor they are not necessarily stupid. They don't want to be herded into clinics.

Very interesting that the last day of his employment, George W. Sullivan,the state inspector general provides a "new" report faulting the managed care Medicaid program. The man has been State Inspector General for so long, with so little movement within his office that many thought he had mummified in there.

So Inspector Gadget is hanging up his cloudy magnifying glass. Can anyone tell us what "study" or action he ever took that wasn't already revealed by either a Globe, Herald or for that matter Patriot Ledger second stringer? This guy is a hack,and thanks to Patrick and good old Swifty, sucked off at the public teat for 10 years, thinking he was important, when impotent was the correct term.

Inspector Gadget finally has to turn in his magnifying glass and parking space. After 10 years of sucking at the public teat, this gladding handing hack is finally off the state payroll, but watch out he may show up elsewhere! Can anyone point to any report that he did that wasn't already written about by a second string Patriot Ledger reporter, or covered by the Globe or Herald? His staff is a bunch of Finneran lay-abouts who had no where to go when felonius Tommy went out of office, and we have old Swifty to thank for him ever getting this job in the first place, another unqualified "leader".

In Florida and from what I recall in my days practicing in MA and from my fellow physicians who are still crazy enough to attempt to practice in this state, Medicaid pays doctors approximately $20 to spend 20 minutes with a patient. It actually costs more to bill the visit. As a result there a very few if any doctors in the state that take Medicaid. FL has also attempted managed care which pay about double what Medicaid pays. This is covers the cost of billing the visit and there might be $10 left over for the doctor. Again no one is really signing up to take these plans. Furthermore, and more important the Medicaid managed care plans make it nearly impossible to practice medicine where it takes months to get a test approved and with that the cost to the practice in staff time does not justify the practices expenses. Finally, there is a two to three fold no show rate with Medicaid patients which is another reason physicians refuse to see them. All of the above sends patients into ER's and to hospital based practices which in turn exponentially drives up the cost of health care. A simple solution is to pay physicians Medicare rates and remove the red tape involved for caring for these patients. Then and only then will you find physicians who willing to see Medicaid patients. As a result you will be keeping them out of the ER and away from the more expensive hospital based practices. These patients will also receive better preventative care and as a result Medicaid costs will actually decrease. Unfortunately, doing the logical thing is often impossible when government is involved.