Medicaid must be destroyed.

The author's opening line says just what I would have: the Republicans are nothing if not persistent. While they're always on message, the message boils down to "if you're not making a fat salary, you can go to hell."

Next month, a commission appointed by the Bush administration will issue its final recommendations for reforming the program--recommendations that look suspiciously like proposals Bush tried and failed to push through Congress three years ago, largely because lawmakers feared they would leave the poorest and sickest Americans without enough health care. (. . .)

The administration has touted this commission as "bipartisan." But, in contrast to some past commissions on entitlement-reform that had truly bipartisan character (with representatives from a reasonably broad philosophical spectrum), Bush's secretary of health and human services, Mike Leavitt, handpicked the voting members. The administration offered congressional Democrats the opportunity to appoint its own members, but it refused to give those who would be selected voting power. (The Democrats, quite understandably, boycotted the commission altogether.)

Given this makeup, the commission's recommendations are about what you'd expect. One big idea is privatization--in other words, using HMOs or other forms of managed-care plans to deliver health insurance to the poor, rather than providing insurance directly from the government. Most states already place at least some of their beneficiaries in managed care. What's apparently different about the commission's recommendations is a push to increase the use of managed care among the elderly and disabled.