Letters to the Editor

Wednesday, August 26, 2009 at 10:41pm

 

Lip service doesn’t heal

It is very difficult for me to understand what possible relevance the article by Reps. Marsha Blackburn and Phil Roe ("TennCare Lessons for Health Care Reform," July 27) had to do with the pending national debate, except for “allowing them” to experience once again the joy of bashing TennCare?

There is not one positive or constructive suggestion in the entire article, and in fact the only subject that seems to interest them, pro or con, is the possibility of a government-run health care option.

Instead, the authors content themselves with a misleading and inaccurate summary of TennCare's sad history, on the apparent assumption that if TennCare was bad, then the new reform proposal (they do not say which one) must be worse, even though the two have nothing to do with each other.

Blackburn and Roe characterize TennCare as "universal single payer care" and President Obama's goal as "universal care," thus establishing (in their minds) that if two things sound alike they must be alike.

But TennCare was not "universal," even within the small "universe" of Tennessee, and it certainly was not intended to be "single payer." Rather it was intended to lower costs and expand coverage through managed care exercised by various qualified provider organizations in competition with each other. 

But many of the providers were not qualified, there was little or no management of the care provided and by the end, any real semblance of competition had been eliminated — while virtually all risk was assumed by the State. So of course TennCare didn't work because it was never properly implemented.

If it is true, as the authors charge, that patients with nothing more than a cold incurred high costs for doctor visits and medication when they should have just taken an over-the counter remedy, then true managed care was not occurring or these unnecessary expenditures would not have been authorized or reimbursed.

On the other hand, of course, if people are really ill, then it is more economical (and patients are better off) if they do see a doctor instead of treating themselves and eventually winding up in an emergency room, which is the most expensive option of all.

Of course, these stories — like the authors' repeated claim that private employers opportunistically dropped their coverage and "forced" workers on to the TennCare rolls — are virtually unverifiable and unquantifiable because of the inadequate data collection and analysis from which TennCare historically suffered.

The people cast out by [TennCare] are a large component of the the group which needs health care reform the most — whether through some sort of government-run plan or otherwise.

People with no health coverage probably will not mind if a "government bureaucrat" is involved in the process that provides them with necessary care and treatment. The bugaboo that the new health care system will put another person "in the exam room" with the patient and his or her doctor should not frighten anyone anyway, since all but the ‘most lavish’ current plans already place limits on costs and availability of certain procedures and require prior authorization for much if not all of the treatment provided.

Like most opponents of reform, Blackburn and Roe give lip service to "affordable basic health care for all Americans," but they say that "creating a plan like TennCare is not the right answer." It would be more correct to say that creating a plan like TennCare is not the right question. The question is how to meet the health care needs of all Americans, and on this subject Blackburn and Roe have nothing to offer.

Michael S. Lottman, 37082

Send comments via e-mail to letters@nashvillecitypaper.com

 

 

299 Comments on this post:

By: dargent7 on 8/27/09 at 4:52

Remember that "game" where you had to count something in a paragraph? Well, this LTE has TennCare 11 times.
It's 5:00am...let's get OFF topic quickly.

By: Kosh III on 8/27/09 at 7:12

To expect intelligence from Marsha is unrealistic.

What exactly do Republicans propose?
They offered nothing during their 12 years of dominance in Congress, nothing during the 8 years of Shrub--except of course wars, spending sprees, corporate welfare, fraking the Constitution, gay-hating etc etc

By: dargent7 on 8/27/09 at 7:27

It's 7:30...where is everyone? No Titans game, no one at Sommet Center.
Do the posters have jobs?

By: chiefpayne568 on 8/27/09 at 7:35

Kosh,

Here you go:

Republicans Have Offered Three Alternative Health Care Reform Bills
http://www.cnsnews.com/news/article/52896

FTA: The three Republican bills total almost 400 pages and have been on the table since May and June.

In May, Republicans in the House and the Senate formed a bicameral coalition to produce the130-page “Patients Choice Act of 2009.”

In June, Sen. Jim DeMint (R-S.C.) introduced the “Health Care Freedom Plan,” a 41-page proposal.

And in July, the Republican Study Committee, under the leadership of Rep. Tom Price (R-Ga.), unveiled the “Empowering Patients First Act,” a 130-page plan.

Some of the provisions included in one or more of the bills include: investing in preventive medicine, an overhaul of Medicaid, reduction of abuse and fraud in the Medicare program, supplemental health insurance for low-income families, tax credits for health insurance, and a ban on federal funds being used for abortions.

By: house_of_pain on 8/27/09 at 7:38

Another deja vu LTE. I don't really have any more to say about this topic.

By: slacker on 8/27/09 at 7:50

I vehemently stand by my previous comments on this matter, but might change my mind.

By: chiefpayne568 on 8/27/09 at 7:52

Wow. Be careful getting old in the UK!

'Cruel and neglectful' care of one million NHS patients exposed

One million NHS patients have been the victims of appalling care in hospitals across Britain, according to a major report released today.

http://www.telegraph.co.uk/health/healthnews/6092658/Cruel-and-neglectful-care-of-one-million-NHS-patients-exposed.html

By: chiefpayne568 on 8/27/09 at 7:59

This is only true IF you count those who were discouraged and stopped looking for a job and those who have gone to part time hours rather than full time hours - which isn't normally included in the official jobless rate used by the government.

But this IS a sobering thought.

Real US unemployment rate at 16 pct: Fed official
http://www.breitbart.com/article.php?id=CNG.4452bed82adf3124e5884678e236d7fb.361&show_article=1

By: pandabear on 8/27/09 at 8:08

The problem is that we live on planet Earth and these politicians
live on...heck, I don't know where they live, but it can't be here.

Make them get the same health care that we have and you'll see change
so fast it'll make your head spin.

Make them retire under social security, and not the cush benefits,
lifetime salary ($180k +), lifetime golden health plan, etc and you'll see rapid
changes there too.

They will never give it up, it will have to be taken away from them.

I wonder If we had a revolution party, would anyone attend ? (byob)

By: bfra on 8/27/09 at 8:08

d7 - Most Metro & State employees don't get to work until 8:00AM and they have to get a cup of coffee before starting their online postings instead of the work, taxpayers are paying for.

By: chiefpayne568 on 8/27/09 at 8:10

Man, I sure hope THIS prediction is wrong!

New projection: 2.3 million fewer people working in 2010
http://keithhennessey.com/2009/08/26/new-projection/

By: chiefpayne568 on 8/27/09 at 8:21

Panda,

Well, according to some, the debates are a peaceful revolution taking place.

Still, you're points about the politicians not wanting to live under the same conditions they impose on us are valid!

By: Kosh III on 8/27/09 at 8:21

chief

Nothing in that about universal coverage.
Tax credits. Same old rich man solution. Let's see how that works shall we?
Husband, wife 2 kids. Income is just enough to make ends meet--barely.
Husband gets sick and goes to the ER then stays 2 days in the hospital. Total cost 15 thousand. Has to pay out of pocket. Hmmmm. Husband is not Lamear or Dorker and can't pay 15 grand out of pocket change. Goes into debt to try to pay it. Gets a tax credit for a portion of it and saves maybe 1/3 of the cost. Still in debt. Still doesn't have coverage because they both work for small companies that can't afford employee coverage, husband now has pre-existing condition and can't get private coverage. Medicaid does not offer eligibility because he is not a child nor is he pregnant.

That is not a real option. It's the same smoke and mirrors the Grand Old Posterior has been offering since Bush41.

By: Dragon on 8/27/09 at 8:22

Why is it so unreasonable to look at Massachusetts or Tennessee to see what did and didn't work? The fact that it has been attempted and failed should provide valuable lessons to be incorporated into the federal program.

And, why is healthcare cost being ignored? Where is tort reform? Where is interstate competition?

Common sense will tell you that merely adding high-usage and uninsurable people to insurance policies drives premiums up, not down. The actual cost of providing the medical care, regardless of who pays for it, is being ignored.

By: chiefpayne568 on 8/27/09 at 8:30

Kosh

"Nothing in that about universal coverage."
Obviously...as that is NOT something that conservatives believe we need.

"Tax credits. Same old rich man solution. Let's see how that works shall we?
Husband, wife 2 kids. Income is just enough to make ends meet--barely.
Husband gets sick and goes to the ER then stays 2 days in the hospital. Total cost 15 thousand. Has to pay out of pocket. Hmmmm. Husband is not Lamear or Dorker and can't pay 15 grand out of pocket change. Goes into debt to try to pay it. Gets a tax credit for a portion of it and saves maybe 1/3 of the cost. Still in debt. Still doesn't have coverage because they both work for small companies that can't afford employee coverage, husband now has pre-existing condition and can't get private coverage. Medicaid does not offer eligibility because he is not a child nor is he pregnant. "

So your solution is to tax the "rich" to pay for universal health care...but what happens when that doesn't pay for it all (or for that matter, since the "rich" have money, they leave the country to prevent paying these taxes)? Why then, they hit the middle class, you and me. And as they have mentioned, it will cost a great deal to pay for all this healthcare.

Frankly, I would rather they do NOTHING in DC about healthcare rather than pass this lousy bill!

By: chiefpayne568 on 8/27/09 at 8:34

Dragon,

"Why is it so unreasonable to look at Massachusetts or Tennessee to see what did and didn't work? The fact that it has been attempted and failed should provide valuable lessons to be incorporated into the federal program."

You've answered your own question with this one. It's because if they DID look at those healthcare systems, then they would have to admit that they failed...and they don't want to do it.

"And, why is healthcare cost being ignored? Where is tort reform? Where is interstate competition?"

Because if healthcare cost is acknowledged, then most would have sticker shock and not touch it with a 10 foot pole. Tort reform would hurt the lawyers who will make money right now and will in the future whether the bill passes or not. Interstate competition would allow the market to do what the public option does, and they don't want to lose the public option.

This is my opinion.

By: chiefpayne568 on 8/27/09 at 8:41

Wow...just wow.

You Think $9 Trillion Sounds Bad?
http://economistmom.com/2009/08/you-think-9-trillion-sounds-bad/

FTA: "If you start with CBO’s more pessimistic baseline budget outlook of $7 trillion in deficits (by the way, the equivalent pre-policy baseline estimated by the Administration is $6.259 trillion), then add in the CBO-estimated cost of policies that have a good chance of coming true in the future (but aren’t yet written into law), you can come up with a projection that is perhaps more “plausible” than both the Administration’s (optimistic) $9 trillion and CBO’s (naive baseline-constrained) $7 trillion. That’s what we at Concord try to do when we come up with our “Concord Plausible Baseline,” which based on today’s CBO report shows that current policy would lead to $14.4 trillion in deficits over the next 10 years."

By: Blanketnazi2 on 8/27/09 at 8:48

Don't worry, Kosh. Just get a job flipping burgers at McDonalds and that'll solve all the problems.

By: chiefpayne568 on 8/27/09 at 8:51

Blanket,

At least it would keep him in private insurance rather than public option.

By: Kosh III on 8/27/09 at 8:51

Here is a nice off topic offering Tell the President to bare it all

http://jezebel.com/5344988/birthers-want-to-see-obamas-penis

By: Kosh III on 8/27/09 at 8:53

Chief do not put words in my mouth
I did NOT say to tax the rich. I said tax credits are a rich man's solution because it reflects the mindset that healthcare can be paid in cash up front and get a nice IRS credit later.

Nice to see you admit that you want no change. I am sure the executives at BCBS will invite you onto their yacht for Labor Day.

By: Kosh III on 8/27/09 at 8:56

Chief
What's wrong with public option. Why do you hate the VA healthcare system? And Medicare? They both work better than private options.

By: chiefpayne568 on 8/27/09 at 8:58

Looks like Krugman believes single payer option would kill out private insurance.

Paul Krugman Admits Public Plan is Incremental Step Towards Single Payer
http://tinyurl.com/mn2nlg

Of course Krugman says it's "ridiculous" now that it could do away with private health insurance. Pretty inconsistent, isn't he?

This Week-Paul Krugman: Public Option opponent's arguments are "sheer nonsense"
http://tinyurl.com/m8mlp9

By: Funditto on 8/27/09 at 9:00

Make health insurance companies non-profit. take the shareholders and the execs out of the loop and voila. everyone can afford it and all is well with the world.

By: chiefpayne568 on 8/27/09 at 9:03

Like him or hate him, you have to admit Limbaugh was right about this one, even though a lot of liberals got angry with him about it. It IS what they want to do now.

Rush gloats that he was right in predicting Democrats would name health care bill after Ted Kennedy

http://mediamatters.org/limbaughwire/2009/08/26#0035

By: gdiafante on 8/27/09 at 9:06

Yawn...some people need to get a life.

By: chiefpayne568 on 8/27/09 at 9:07

Funditto,

Ok...so if you make health insurance companies non-profit, and do away with shareholders and execs - then WHO would run these companies?

Only one left, unless you want to make it charity of sorts, is the federal government...which, in my opinion, will not reduce costs as I've never seen anything touched by the federal government reducing costs in any way.

By: MamaG on 8/27/09 at 9:08

RIP Dominick Dunne.

Scuttlebut in EN says Publix is coming to Inglewood! Yippee if it's true. They would build a store where the old Inglewood Bowling Alley was, also taking the space of (former) Eckerds and possibly Hollywood Video. I hope this rumor is true. Also heard Whole Foods is looking at EN for possible location.

By: Captain Nemo on 8/27/09 at 9:13

By: dargent7 on 8/27/09 at 4:52
Remember that "game" where you had to count something in a paragraph? Well, this LTE has TennCare 11 times.
It's 5:00am...let's get OFF topic quickly.

Here are some numbers

9:12 and there was 25

11 by a total waste

By: Kosh III on 8/27/09 at 9:13

Mama
What's so great about Publix? I have tried them several times and find their prices to be substantially higher overall. Give me another Aldi's.

By: MamaG on 8/27/09 at 9:13

Hey Beatles fans, did anyone see the show about the Beatles on tv last night? I didn't see it but saw it was coming on. I think it was on VH1 so would probably be repeated for those of us who might have missed it.

By: chiefpayne568 on 8/27/09 at 9:15

Kosh,

"What's wrong with public option. Why do you hate the VA healthcare system? And Medicare? They both work better than private options."

Interesting you say that, as both are nearly broke and both have problems too, similar to the private insurance companies, in that people have problems getting diagnosis and treatment.

Point is, if you go with a public plan, you add buerocracy levels IMO, putting even more layers between you and your doctor than you have now. Also, the care given in both isn't as great as private insurance, because the doctors and hospitals know they are limited on how much they can charge for the services...so, again IMO, you will get more limited, standardized healthcare because there's no incentive for them to go the extra mile for you.

Yes, I do have the ability to go to the VA if I ever need to...but I will be hardpressed to ever find the time when I will willingly go there.

By: MamaG on 8/27/09 at 9:16

Kosh, I like Aldi's too but I like the variety of choices Publix has. I like their homemade breads and desserts. I like that they offer sushi and there is no place in EN to purchase any decent seafood and barely any meats. For me, it will be the place I pick up what I can't pick up at Aldi's or Kroger's.

By: dargent7 on 8/27/09 at 9:17

Kosh III: Aldi's? The food/ produce/ anything there is 3rd rate. Yes, cheaper, but rejects and seconds from there retailers.
"Harris Teeter" is the way to go. Everything that store has is 1st rate.
The great OZ has spoken.

By: MamaG on 8/27/09 at 9:18

And I'm excited about the possibility of having a Publix in my neighborhood. Evidentally you've never shopped at the EN Kroger. The Inglewood one is quite a bit better but I get tired of "working" there when I shop. I do love the new Aldi's at Eastland though!!

By: gdiafante on 8/27/09 at 9:18

Yes, mama, it was the Anthology mini-series that was created in the mid-90's...the second episode is on next Wednesday. It shows fantastic old footage, and I thought the audio/video of the Melbourne concert was outstanding...why haven't they released that concert on DVD yet??

By: chiefpayne568 on 8/27/09 at 9:20

Kosh,

"What's so great about Publix? I have tried them several times and find their prices to be substantially higher overall. Give me another Aldi's."

Well, Publix does have higher prices...but they also have pretty fresh foods and pretty good service. Still, if you're more worried about the prices of foods, you'd do better to go to Food Lion or some other store. The service isn't as good but the prices are lower...and the foods pretty fresh too.

By: MamaG on 8/27/09 at 9:21

darge, I've never had anything from Aldi's that wasn't fresh. Their produce is significantly cheaper and just as good as Kroger. I doubt HT would ever come to EN anyway.

By: MamaG on 8/27/09 at 9:22

By chief:
Well, Publix does have higher prices...but they also have pretty fresh foods and pretty good service. Still, if you're more worried about the prices of foods, you'd do better to go to Food Lion or some other store. The service isn't as good but the prices are lower...and the foods pretty fresh too.

Chief, Food Lion is NOT cheap on anything. Check out Aldi's.

Gotta run for a few hours...be back later this afternoon!

By: gdiafante on 8/27/09 at 9:25

Nothing's wrong with Aldi, we go there, to Kroger and Publix. It's all about what deals they're having.

My wife does the shopping and can use the combination of all three of those stores and save us $20-$30 a week. No kidding. Variety is the spice of life...

By: Blanketnazi2 on 8/27/09 at 9:28

HT is high unless you hit the sales and coupons and if you do that you get a heck of a deal. Right now they're doubling coupons up to $1.98.

By: dargent7 on 8/27/09 at 9:29

What a day it's shaping up to be...Aldi's vs. Kroger's vs. Publix. Who gives a shi**t?

By: chiefpayne568 on 8/27/09 at 9:32

Wow...this is one heck of a comic writer! It may be a comic but it sure does have a moral to it.

Steve Ditko’s Eternal Relevance: ‘In Principle: The Unchecked Premise’
http://tinyurl.com/lq3wh8

By: Kosh III on 8/27/09 at 9:43

Mama
Yeah, I shop them all: Krogers, Walmart Grocery, Aldi. Shop around if possible.
I often check Hills around 7am on the weekends. The Madison store puts out meats that are at or near the sell-by date at a great discount. Last Sunday morning I paid 30 bucks and got enough meat for the two of us for two weeks---but you have to be picky about it, some of it is not so great. Otherwise I NEVER shop at Hills.

Yes, Food Lion is expensive.

Service? For what? I use the self-serve check out and IF I need help, the Madison store has several long-time employees who know what they are doing.

By: Captain Nemo on 8/27/09 at 9:44

Change of subject.

This pass weekend I saw the movie District 9. It was better than I first thought and it does not paint a very good picture of humanity. It remined me of what it must have been to live in the Warsaw ghetto or in preasent day Palestine. Or what it was like in Apartheid South Africa.

By: pswindle on 8/27/09 at 9:45

This just shows that Blackburn is in way over her head. If she doesn't understand the health issue, how can she explain it to others. She is a non-thinker, and she does what the other GOP tell her to do.

By: Kosh III on 8/27/09 at 9:46

dargent7 on 8/27/09 at 9:29
What a day it's shaping up to be...Aldi's vs. Kroger's vs. Publix. Who gives a shi**t?

------------
Who said in the very FIRST post today that we needed to get off-topic?? LOL

By: Captain Nemo on 8/27/09 at 9:49

pswindle it sound to me that you think that Blackburn is just another programmed machine for the GOP.

By: slacker on 8/27/09 at 9:50

Two Metro councilmen, are introducing a bill to allow you'ens to keep small flocks of fowl, to produce eggs and feathers for personal use. Did not mention if neck wringing, will be allowed for Sunday dinner.

By: Blanketnazi2 on 8/27/09 at 9:51

oh for the love of, well, nothing......we do not need chickens in town!