There are solutions to the health care problems facing this country, but we can’t achieve those solutions without somebody getting the short end of the stick.
That’s one of the points made by MedSolutions President and CEO Curt Thorne in framing a discussion on health care reform Tuesday at Belmont University that included keynote speeches from Congressman Jim Cooper and Gov. Phil Bredesen.
“Realizing the benefits of meaningful solutions requires that we tell the truth, that there will be losers, and we need to get that out on the front burner,” said Thorne, who was joined on the panel by SHOUTAmerica Executive Director Landon Gibbs and health policy researcher Dr. Wilhelmina Leigh.
One of the potential losers in reform is the state of Tennessee, Bredesen argued. Echoing some of his recent comments, Bredesen said the bill expected to be voted out of the Senate Finance Committee on Tuesday, which would expand coverage to Americans through the Medicaid program, could cost the state about $750 million.
Given that Tennessee’s revenue is not expected to return to 2008 levels until 2013, it will be difficult to shoulder those additional costs when the state has depleted reserves, a battered pension system, and has been unable to provide raises to state employees for five years.
“Almost any version (of reform) which ultimately passes is going to include a substantial expansion of Medicaid as a part of it,” Bredesen said. “I’m glad they’re trying to (achieve reform) without increasing the federal deficit… but to turn around and increase the states’ deficits as a way of handling it, that does not seem like an appropriate way of handling it.”
Cooper — who is optimistic to the point of being 60 percent to 70 percent sure a reform bill will pass late this year or early next — pointed out that the possibility that providers could be losers in reform is spurring additional debate about a public option.
The Senate’s reluctance to include a firm individual mandate in legislation may mean covering fewer than a previously estimated 40 million Americans who don’t have insurance — not what doctors, hospitals, and insurance companies had hoped for in negotiations. This has created “further talk of the so-called public option,” of which Cooper is in favor if properly drafted.
In keeping with the event’s somewhat broader discussion of reform issues, Cooper also explored nine key points about the reform debate, including that doing nothing on health care in 2009 is “very risky,” Congress’s slowness on controversial topics may drag the debate out for months, and that contrary to what some people say, there is no Obama bill, only legislation that Congress has drafted.
“It’s not about authorship, it should be about craftsmanship — whether it’s a good bill or not,” he said. “We need a good health care reform bill this year.”
From Bredesen’s perspective, the current proposals focus only on expanding coverage and not mitigating the rising costs of health care in this country, which make them less than ideal.
“Perhaps the incremental approach to this is the way it has to happen with something as big as government and health care,” he said. “But I really had hoped for something more.”