HOW TO SPEAK REPUBLICAN

Jeb Bush, speaking Republican:

Calling his proposal "empowered care," Governor Bush said when he announced it here on Jan. 11 that it would offer more choice and flexibility to users....

"Our proposals put the focus back on the patient by encouraging strong patient-doctor relationships and allowing competition in the market to drive access and quality of care," the governor said in putting forward his proposal here last week.

What Jeb's talking about, in English:

Mr. Bush is proposing that the state's 2.1 million Medicaid recipients be allotted money to buy their own health care coverage from managed care organizations and other private medical networks. If enacted, the program would make Florida the first state to allow private companies, not the state, to decide the scope and extent of services to the elderly, the disabled and the poor, half of them children.

...Florida ... would not be the only state to incorporate managed care into its Medicaid program. Most states do. The difference is that other states impose strict conditions about who will be covered and for which services. Under Governor Bush's plan, the private companies would make those important decisions without government interference.

"It's very radical," said Joan Alker, senior researcher for the Health Policy Institute at Georgetown University. "It seems clear that the intent is really based on the notion that the H.M.O.'s and private insurers will have substantial flexibility to make a profit at the expense of the Medicaid beneficiary, who essentially assumes the risk of not getting the services they need. That's unprecedented in Medicaid, really."...

So letting for-profit companies decide what medical services will and won't be covered under Medicaid -- even for children -- is "allowing competition in the market to drive access and quality of care." And letting HMO bureaucrats screw up claims is "put[ting] the focus back on the patient by encouraging strong patient-doctor relationships."

Yeah, that's an Orwell grave-roll you hear.