At first blush, it's tempting to lump the wasteful spending of tax dollars state Auditor Crit Luallen's staff uncovered at Passport Health Plan with the pile of dirty laundry from the Kentucky League of Cities, the Kentucky Association of Counties, the Blue Grass Airport and other quasi-public agencies whose officials lived the high life largely on the public dime.

And there is much about the Passport situation mirroring the circumstances at those other organizations: power run amok; exorbitant executive salaries and bonuses; lavish spending on travel to upscale resorts, dining at ritzy eateries, parties, gifts and the like; and blatant conflicts of interest.

And in Passport's case, $1 million spent hiring outside lobbyists even though its two top staffers — executive vice president Shannon Turner and associate vice president Nici Gaines — were registered lobbyists themselves.

In one way, though, Passport's profligacy deserves special condemnation. Every dollar Passport executives spent on their own pleasurable pursuits, on lobbying to insure tax money kept flowing their way, on buying goodwill in the Louisville area or on any other unnecessary expense was a dollar taken away from providing Medicaid services to the most vulnerable, needy members of society.

Not just the vulnerable, needy Kentuckians in Passport's 16-county service area. Not even just vulnerable, needy Kentuckians in general.

A Medicaid dollar spent wastefully anywhere is a Medicaid dollar denied to the deserving Americans everywhere. And since Passport was set up solely to manage Medicaid care in those 16 counties, every dollar passing through the agency can be considered a Medicaid dollar.

As was the case with the other recent spending scandals, a board — dominated by University of Louisville officials — tasked with providing oversight failed to fulfill its fiduciary responsibility by either turning a blind eye to the excessive spending or condoning it.

The latter seems likely since the audit found the board itself was responsible for the questionable distribution of tens of millions of dollars in excess funds to the benefit of the organizations represented on the board.

And Dr. Larry Cook, board chairman and U of L's executive vice president for health affairs, continues to defend the indefensible practice of spending Medicaid money on lobbying and public relations efforts designed to keep the tax dollars flowing into Passport's ample coffers.

No doubt, the magnitude of Passport's lobbying activity helped fuel discussions during the 2010 General Assembly of expanding its reach outside the counties it now serves. While a managed-care approach to Medicaid might still find considerable legislative support, and rightly so, we suspect few if any lawmakers would propose a Passport expansion now — at least not without major changes in the organization.

Even more absurd than Cook's defense of Passport's lobbying efforts was his initial assertion that it was not a public agency and therefore was immune to a state audit.

When every penny an agency receives comes from tax revenues, it is most definitely a public agency subject to opening its books for public scrutiny. If Passport officials had recognized this sooner, they might have saved themselves a great deal of embarrassment.