Monday, August 25, 2014

Medicaid and the Future of Health Care in the USA: Interview with Matt Salo

[Episode 88] Today's episode of the Social Work Podcast is about Medicaid. Medicaid is one of two health insurance programs signed into law on July 30, 1965 by President Lyndon B. Johnson. Medicaid has long been erroneously thought of as "insurance for the poor." Medicare, the other program LBJ signed into law, is thought of as "insurance for older adults." Are you bored yet? Yeah, me too.

"An hour long episode on Medicaid? Are you serious?" I hear you. I've dealt with Medicaid audits, those mind-numbing time studies, and the pathologically rigid billing regulations. But before you hit the "skip" button and head over to one of my competitors - Podsocs, inSocialWork, or the Social World Podcast, consider this: Medicaid has been called "the most important program [in the USA] that nobody understands." (Matt Salo, November 22, 2013). Did you know that it is a 450 billion dollar health insurance program that served 72 million people a year? 72 million - that's twice the population of Canada, and more than the populations of France, Italy, Germany, and the UK.

In order to get a handle on this enormous program I spoke with someone who is in the news on nearly a daily basis answering questions about Medicaid - Matt Salo. Mr. Salo is the executive director of the National Association of Medicaid Directors (NAMD), "a bipartisan, professional, nonprofit organization of representatives of 56 state Medicaid agencies (including the District of Columbia and the territories). NAMD is committed to providing a focused, coordinated voice for the Medicaid program in national policy discussion and to effectively meet the needs of its member states now and in the future" (NAMD website).

I spoke with Mr. Salo about his role in NAMD and the function of the organization. We spoke at length about the ethical and economic dilemma that has faced Medicaid lately - the development of a cure for Hepatitis C (Sovaldi). As Mr. Salo explained in this New York Times piece from August 2, 2014, Medicaid directors estimated that covering this cure for Hepatitis C could drive up the cost of health care by 10% to 15% across the board. Mr. Salo and I talked about how social workers can advocate for clients within a system that is constrained by economics. In the second half of our conversation, Mr. Salo described a future for health care that addressed many of the criticisms of the way managed care was conceptualized. He talked about the role of social workers in this new world of integrative behavioral health.

I'm VERY interested in your thoughts about Mr. Salo's thoughts on medicaid. Please join me in an on-going online discussion. If you're on Twitter, use the hastag #medicaid. If you're on Facebook, please go to the Social Work Podcast Facebook page and leave your comments. And if you listened to the very end of the episode and know the answer to the question "how does Jonathan know Matt Salo" please give the answer on the poll at the top of the page. Thank you!

Download MP3 [57:59]


Matt Salo was named the first Executive Director, and at the time, only staff member of the National Association of Medicaid Directors (NAMD) in February 2011. This was a bit of a homecoming, as his first real job out of college was working for the Medicaid Directors from 1994 to 1999.

Matt formerly spent 12 years at the National Governors Association, where he worked on the Governors’ health care and human services reform agendas, and where he firmly believes he was responsible for securing the entire tobacco settlement for the states, getting more than $100 billion in state fiscal relief, and in modernizing the Medicaid program.

Matt taught high school for two years at T.C. Williams High in Alexandria, VA, which actually bears no resemblance to the school they profiled in the Disney movie, Remember the Titans. He holds a BA in Eastern Religious Studies from the University of Virginia, and is still trying to find ways to explain how that got him to where he is today.



Resources and References

APA (6th ed) citation for this podcast:

Singer, J. B. (Producer). (2014, August 25). #88 - Medicaid and the future of health care in the USA: Interview with Matt Salo [Audio Podcast]. Social Work Podcast. Retrieved from