Should we let the federales run Medicaid in the states?

Tommy Thompson’s latest crusade involves trying to get the feds to run Medicaid’s programs for the elderly (rather than just share in the funding), and let the states focus on services to younger populations.  He’s been touting this plan lately, at the National Governors Association annual meeting, and through the media.  He says now he’s always thought this would be a good idea — more efficient to have one central operation vs. 50 local operations — though some folks believe that his current client list might have at least something to do with his support for this notion.  (Original articles here and here; Washington Post free registration required.) 

So far the discussion of his plan seems to be short on details. 

Remember: this is a guy who (a) sold Medicare Part D by assuring Congress that it would cost no more than $400 billion over 10 years and then saw his subordinates investigated over the details of what did they know (about the fact that the estimate was way off) and when did they know it and (b) announced he would have an RFID tag implanted after a joining the board of a corporation in that line of business. 

Now, while I believe that in the future each of us may have a chip implanted with all sorts of useful information (though we might need to carry explanations of why we’re setting off overly-sensitive security devices, as some other RFID pioneers and even patients receiving radioactive isotopes have experienced), I am still wary of suggestions that the health care system can save money by federalizing some of its financing processes.